半肝血流阻断的临床应用

CLINICAL APPLICATION OF HEMIHEPATIC BLOOD-SUPPLY BLOCKAGE TECHNIQUE

目的 以客观指标观测与评价半肝血流阻断术在肝叶切除中的应用效果。方法 经肝实质途径和经肝的板途径行半肝血流阻断,观测术前后半肝血流阻断组（半肝组）与全肝血流阻断组（全肝组）AKBR及术后并发症、死亡率、平均住院时间等。结果 阻断复流后,AKBR全肝组显著低于半肝组（P<0.05）,且复流后AKBR回升慢于半肝组;全肝组合并肝硬变复流时AKBR较未合并肝硬变者下降更明显,半肝组两者变化不明显;全肝组术后并发症、死亡率、平均住院时间较高于半肝组。结论 肝叶切除术采用半肝血流阻断术简便、安全,特别适用于HCC合并肝硬变病人。

objective to observe and evaluate the effect of hemihepatic blood -supply blockage technique in hepatectomy. Methods Hemihepatic blood- supply blockage was performed through hepatic parenchymal or plaque hilar pathway. Pre - and postoperative indices were observed and determined between group of hemihepatic blood -supply blockage(HHBD)and group of total hepatic blood-supply blockage(THB), which included ADBR, complications, mortality and average hospitalization time, etc. Results After release of blood - supply blockage, AKBR in THB group was lower than that of HHB group;in THB group, AKBR decreased more obvious in the patients associated with cirrhosis. However, AKBR changed unobviously in HHB group; the complications, mortality and hospitalizatoin time were higher than that of HHB group. Conclusion During hepatectomy, hemihepatic blod - supply blockage technique is simple, convenient and safe. This technique especialy fits for patients associated with cirrhosis.