不同肝血量阻断方法对原发性肝癌手术患者预后的影响

Prognosis affect of different methods for blocking hepatic blood volume with liver cancer surgery

目的探讨不同肝血量阻断方法对肝癌手术患者预后的影响。方法回顾性分析原发性肝癌患者的105例,分为全肝蒂阻断组38例、半肝阻断组32例、区域阻断组35例,对每组行不同肝血量阻断方法进行治疗。结果区域阻断组术中出血量、术中输血情况、肝血阻断时间、住院时间少于全肝蒂阻断组及半肝阻断组(P<0.05)。区域阻断组术后第1、3、7天,血清谷丙转氨酶(ALT)、总胆红素(TBIL)水平明显低于全肝蒂阻断组及半肝阻断组;而术后第3、7天清蛋白(ALB)水平明显低于全肝蒂阻断组及半肝阻断组,差异有统计学意义(P<0.05)。3组患者近期疗效差异无统计学意义(P>0.05),但区域阻断组患者完全缓解(CR)率明显高于其余两组,差异有统计学意义(P<0.05)。结论对原发性肝癌患者应用区域血流适时阻断技术能最大限度减少肝组织缺氧、缺血时间,有效控制切肝出血量。

Objective To investigate the prognosis effect of different methods for blocking hepatic blood volume in patients with liver cancer .Methods The clinical data of 105 cases with different methods （whole liver hepatic pedide block concluded 38 cases , semi-block 32 cases ,regiosnal block 35 cases） for blocking hepatic blood volume with liver cancer were analyzed .Results The bloc-king blood loss ,intraoperative blood transfusion ,liver blood blocking and hospitalization time of regional block group were less than those of the whole liver hepatic pedicle block group and semi-block group（P〈0.05） .The levels of ALT ,TBIL of regional block group were lower than those of the hepatic pedicle blocking group and semi-liver blocking group after the first 1 ,3 ,7 d .The levels of ALB of regional blocking group were lower than those of the blocking hepatic pedicle group and half of the liver blocking group （P〈0.05） .There was no significant difference in the short-term effect among the three groups（P〉 0.05） ,but the rate of rea blocked complete remission was significantly higher than that of the other two groups（P〈0.05） .Conclusion The application of regional blood flow in patients with primary liver cancer timely blocking technology can minimize liver tissue hypoxia and ischemia time ,effectively control the liver bleeding cut .