不阻断入肝血流切除合并肝硬化肝癌的临床探析

Clinical Analysis of Hepatectomy for Liver Crrhosis and Liver Cancer without Hepatic Blood Inflow Occlusion

目的:探讨合并肝硬化肝癌采用不阻断入肝血流切除术治疗临床效果。方法:本次研究选择的对象共80例,均为我院2010年9月至2012年9月收治合并肝硬化肝癌患者,随机按观察组和对照组各40例划分,对照组采用全肝入肝血流阻断切除术,观察组采用不阻断入肝血流切除术,回顾临床资料。结果:两组术中出血量、阻断时间、手术时间无明显差异(P>0.05)。术前两组谷丙转氨酶(ALT)及总胆红素水平(TB)均无明显差异,术后1d及7d对照组均显著高于观察组,差异有统计学意义(P<0.05)。术后以切口感染、腹水、上消化道出血、肺部感染、胆漏为主要并发症,对照组并发症发生率为20%,观察组为7.5%,观察组显著少于对照组(P<0.05)。结论:采用不阻断入肝血流切除合并肝硬化肝癌具有一定的安全性和可行性,降低了不良事件发生率,对肝功能影响较小,缩短了术后康复进程,改善了患者生存质量,值得在临床推广应用。

Objective：To investigate hepatectomy for liver crrhosis and liver cancer without hepatic blood inflow occlusion.Methods：This study selected objects a total of 80 patients,are all from Sept.2010 to Sept.2012 were combined liver cirrhosis patients with hepatocellular carcinoma.Random in the observation group and the control group each 40 patients.The control group using a whole liver hepatic inflow occlusion resection,The observation group by no blocking blood flow to the liver resection,Review of clinical data.Results：Two groups of bleeding volume,operation time,cross-clamping time has no obvious difference（P0.05）.There were no significant differences in preoperative two groups of alanine aminotransferase（ALT） and total bilirubin（TB）,Postoperative 1D and 7d control group were significantly higher than those in the observation group,The difference was statistically significant（P0.05）.Conclusion：By no blocking blood flow to the liver cirrhosis liver resection combined with certain safety and feasibility,Reduce the incidence of adverse events,Liver function to less effect,Shorten the postoperative rehabilitation process,To improve the quality of life of patients,Worth in the clinical application.