肝下下腔静脉阻断联合半肝血流阻断在肝脏肿块切除手术中的应用

Application of blocking lowhepar inferior venae cava combined half liver in the liver excision surgery

目的评价肝下下腔静脉阻断联合半肝血流阻断在肝脏肿块切除手术中的应用。方法回顾分析该中心病房2010年7月～2011年8月收治的54例肝脏肿块切除病例。接受Pringle法13例,半肝阻断法18例,半肝阻断联合肝下下腔静脉阻断法23例,比较其阻断时间、术中出血量、中心静脉压的变化及术后肝功能变化。结果 3种方法在阻断时间上无明显差异,第3种方法在出血量上优于前两种方法,中心静脉压较前两种方法有显著下降,且术后肝功能损害优于第1种方法,并与第2种方法无明显差异。结论肝下下腔静脉阻断联合半肝血流阻断在肝脏肿块切除手术中可以有效降低中心静脉压,减少术中出血,且不增加肝功能损害。

【Objective】To study application of blocking lowhepar inferior venae cava combined half liver in the liver excision surgery.【Methods】54 cases of liver excision cases of central south university Xiangya hospital ward 60 general surgery in July 2010-August 2011 were reviewed.13 cases accepted Pringle method,18 cases received half live block method,23 cases took blocking lowhepar inferior venae cava united half liver method.The block time,perioperative bleeding,central venous pressure changes and postoperative liver function changes were compared.【Results】Three methods in blocking the time were no obvious difference.The third method was superior to the amount of blood loss in the first two kinds of methods,central venous pressure relatively before two kinds of methods have dropped significantly,postoperative liver damage was better than the first method,and the second method without obvious difference.【Conclusion】The method of block of lowhepar inferior venae cava united half liver can effectively reduce the central venous pressure,reduce intraoperatie bleeding,and do not increase the damage liver function.