不同入肝血流阻断方式在腹腔镜肝切除术中的应用效果

Effects of Two Kinds of Hepatic Vascular Control in Laparoscopic Hepatectomy

目的探讨不同入肝血流阻断方式在肝切除术中的应用效果。方法回顾性分析我院2010年1月至2014年12月期间行腹腔镜肝切除术患者76例,根据术中血流阻断方式分组,A组37例采用全部入肝血流阻断法(Pringle法),B组39例采用选择性入肝血流阻断。对患者术中情况及术后肝功能指标进行对比分析。结果 B组患者术中输血量多于A组,差异具有统计学意义(P<0.05),术中出血量与手术时间两组不存在差异;B组患者肝功能指标在术后1 d、3 d均明显低于A组,差异具有统计学意义(P<0.05),术后7 d两组无统计学差异(P>0.05);住院时间及并发症发生率两组无统计学差异(P>0.05)。结论两种入肝血流阻断方式在腹腔镜下肝切除术中均是可行的,但选择性入肝血流阻断方式对肝功能的保护作用更优。

Objective To investigate the effects of two kinds of hepatic vascular control in laparoscopic hepatectomy. Methods Retrospective analysis was carried out in 76 patients with laparoscopic hepatectomy from January 2010 to December 2014 in our hospital. These 76 patients were divided into two groups according to hepatic vascular control methods,in which group A received Pringle maneuver in 37 cases,and group B received selective vascular control in 39 cases. The operation condition and liver function of two groups were analyzed. Results The transfusion volume of group B was higher than that of group A（ P〈 0. 05）,but there was no difference of bleeding volume and operation time between the two groups（ P 〉0. 05）. The1-day-liver-function after operation and 3-day-liver-function of group A were better than that of group B（ P 〈0. 05）,but there was no difference of the 7-day-liver function after operation between the two groups（ P〉 0. 05）. There was no difference of hospital stay and complication rate（ P 〉0. 05）. Conclusion It is feasible of the two kinds of hepatic vascular control for laparoscopic hepatectomy,but selective hepatic vascular control is better for retention of liver function.