肝段血流阻断技术在肝癌患者精准肝段切除中的应用

Application of hepatic segment vascular occlusion technology in precise liver segmentectomy for hepatocellular carcinoma

目的探讨肝段血管阻断技术在精准肝段切除术中的应用。方法回顾性分析在我院行精准肝段切除的67例肝癌患者的临床资料，其中男51例，女16例，年龄45～66岁。均经病理学证实为原发性肝细胞肝癌。结果67例患者均为单发肿瘤，手术均获得成功。肿瘤直径2～6cm，行肝Ⅲ段切除病例22例，肝Ⅳ段切除病例10例，肝Ⅵ段切除病例35例。手术时间50～120min，平均时间73min；术中出血量50～200ml，平均出血量86ml，患者术中术后均未输血；术后出现切口液化6例，经换药后痊愈，患者术后均未发生胆漏、出血、腹腔感染及肝脏衰竭等并发症；术后住院时间6～11d，平均时间7．8d。术后随访3个月，无肿瘤复发患者。结论肝段血流阻断技术在肝癌患者精准肝段切除中的应用是安全可行的，可有效控制术中出血，减轻了肝脏损伤，町以减少术后并发症的发生，缩短住院时间。

Objective To evaluate hepatic segment vascular occlusion technology in precise resection of liver segment. Methods Sixty-seven cases of liver cancer patients who underwent precision liver segment resection from August 2007 to May 2012 in Qilu Hospital were analyszed retrospectively. There were 51 male patients and 16 female patients, age ranging from 45 to 66 yrs. Results All operations were performed successfully. All cases were with single tumor, the diameter ranged from 2 cm to 6 cm. Resection of segment m was performed in 22 cases, segment Ⅳ in 10 cases and segment Ⅵ in 35 cases. Operation time was 50 - 120 minutes, and the average time was 73 minutes. Blood loss was 50 -200 ml, averaging 86 ml. No patient needed blood transfusion. Postoperative incisional liquefaction was found in 6 cases which were cured with interference in time. There was no bile leakage, hemorrhage, celiac infection and complications such as liver failure. The average hospital stay was 7.8 days. No recurrence was found during 3 months follow-up. Conclusions Hepatic segment vascular occlusion technology was safe and feasible in precise resection of liver segment in liver cancer patients. It effectively controlled blood loss and reduced liver damage.