不同血流阻断方案在原发性肝细胞癌患者手术中的效果对比

Effect comparison between different vascular occlusion schemes in operation for primary hepatocellular carcinoma patients

目的探讨不同血流阻断方案在原发性肝细胞癌患者手术中的效果。方法 84例原发性肝细胞癌手术患者,按照随机数字表法分为实验组和对照组,各42例。手术中,实验组患者采用半肝血流阻断法,对照组采用保留半肝血流阻断法。对两组患者手术时间、术中出血量、血流阻断时间、术后住院时间、术后肝功能不全、术后感染情况进行比较。结果实验组手术时间为(201.35±26.36)min,术中出血量为(508.37±38.47)ml,血流阻断时间为(18.63±2.85)min,术后住院时间为(9.5±1.8)d,术后肝功能不全6例,术后感染8例;对照组手术时间为(173.27±23.74)min,术中出血量为(478.37±42.73)ml,血流阻断时间为(17.74±2.48)min,术后住院时间为(8.9±2.1)d,术后肝功能不全5例,术后感染2例。两组患者手术时间、术中出血量、术后感染发生情况比较差异具有统计学意义(t/χ2=5.130、3.381、4.086,P<0.05);两组患者血流阻断时间、术后住院时间、术后肝功能不全发生情况比较差异无统计学意义(t/χ2=1.527、1.406、0.105,P>0.05)。结论保留半肝血流阻断法相对于半肝血流阻断法运用到原发性肝细胞癌患者手术中可以减少患者的手术时间和手术出血量、减少患者感染率。

Objective To investigate effects by different vascular occlusion schemes in operation for primary hepatocellular carcinoma patients. Methods A total of 84 patients receiving operation for primary hepatocellular carcinoma were divided by random number table into experimental group and control group, with 42 cases in each group. During operation, the experimental group received hemi-hepatic vascular occlusion, and the control group received retained hemi-hepatic vascular occlusion. Comparison was made on operation time, intraoperative bleeding volume, vascular occlusion time, postoperative hospital stay time, postoperative hypohepatia and postoperative infection condition between the two groups. Results The experimental group had operation time as （201.35 ± 26.36） rain, intraoperative bleeding volume as （508.37 ± 38.47） ml, vascular occlusion time as （18.63 ± 2.85） min, postoperative hospital stay time as （9.5 ±1.8） d, 6 cases with postoperative hypohepatia and 8 cases with postoperative infection. The control group had operation time as （173.27 ± 23.74） rain, intraoperative bleeding volume as （478.37 ± 42.73） ml, vascular occlusion time as （17.74 ± 2.48） rain, postoperative hospital stay time as （8.9 ± 2.1） d, 5 cases with postoperative hypohepatia and 2 cases with postoperative infection. The differences of operation time, intraoperative bleeding volume, and postoperative infection had statistical significance between the two groups （X 2=5.130, 3.381, 4.086, P〈0.05）, while there was no statistically significant difference of vascular occlusion time, postoperative hospital stay time, and postoperative hypohepatia between the two groups （t/x2=l.527, 1.406, 0.105, P〉O.05）. Conclusion Comparing with hemi-hepatic vascular occlusion, retained hemi-hepatic vascular occlusion can reduce operation time, intraoperative bleeding volume and infection rate in treating primary hepatocellular carcinoma patients.