两种肝门阻断切除术式对巨大肝癌患者健侧肝组织功能的影响

Two Kinds of Block Resection of Hepatic Portal on Contralateral Non-tumor Liver Function of Patients with Huge Liver Cancer

目的:探讨第一肝门完全阻断顺行切除与选择性阻断逆行切除术式对巨大肝癌患者健侧肝组织功能的影响差异。方法:选取近期收治巨大肝癌患者80例,采用随机抽样方法分为A组(40例)和B组(40例),分别行第一肝门完全阻断顺行切除与选择性阻断逆行切除术式治疗,比较两组患者术后健侧肝组织凋亡指数(AI),细胞内钙离子浓度,丙二醛(MDA),超氧化歧化酶(SOD)及肝功能状态指标水平等。结果:B组患者术后健侧肝组织AI水平显著低于A组,差异有统计学意义(P<0.05);B组患者术后健侧肝组织细胞内钙离子、MDA及SOD浓度水平均显著低于A组,差异有统计学意义(P<0.05);B组患者术后ALT、AST及TBil水平均显著低于A组,差异有统计学意义(P<0.05);B组患者术后PA水平均显著高于A组,差异有统计学意义(P<0.05)。结论:相较于第一肝门完全阻断顺行术式,选择性阻断逆行切除术式可有效保护巨大肝癌患者健侧肝组织功能,减轻缺血再灌注损伤程度。

Objective： To investigate influence differences of two kinds of block resection on contralateral non-tumor liver function of patients with hepatic portal huge liver cancer. Methods： 80 patients with huge liver cancer were chosen in recent years in our hospital and randomly divided into both group including group A（ 40 patients） with first hepatic portal completely blocking anterograde resection and group B（ 40 patients） with selective blocking retrograde resection; and the levels of apoptosis index（ AI） of contralateral non-tumor liver tissue and intracellular calcium ion concentration,malondialdehyde（ MDA）,superoxide dismutase（ SOD） and liver function indexes after operation of both groups were compared. Result： The levels of AI of contralateral non-tumor liver tissue after operation of group B was significantly lower than group A（ P〈0. 05）. The levels of intracellular calcium ion concentration,MDA and SOD of contralateral non-tumor liver tissue after operation of group B was significantly lower than group A（ P〈0. 05）. The levels of ALT,AST and TBil after operation of B group was significantly lower than group A（ P〈0.05）. The level of PA after operation after operation of group B was significantly higher than group A（ P〈0.05）. Conclusion：Compared with first hepatic portal completely blocking anterograde resection,selective blocking retrograde resection in treatment of patients with huge liver cancer can efficiently protect contralateral non-tumor liver function and alleviate the severity of ischemia reperfusion injury.