常温下半肝血流阻断后肝叶切除术的临床应用

The Clinical Application of the Optional Half-hepatic Blood Occlusion for Hepatictomy

目的:通过对79例肝癌的回顾性分析研究,讨论选择性半肝血流阻断与全肝血流阻断肝切除术对患者术后肝功能的影响。方法:37例行选择性半肝血流阻断肝切除术、42例行全肝血流阻断肝切除术。术后对两组病例的各项肝功能指标进行比较。结果:79例无手术死亡。94.6%行选择性半肝血流阻断肝切除术的患者和40.4%行全肝血流阻断肝切除术的患者于术后两周肝功能恢复正常或术前水平。两者比较有统计学差异(P<0.05)。结论:对肝癌伴肝硬变的患者行选择性半肝血流阻断肝切除术可以减轻肝血流阻断对肝功能的损害、术后肝功能恢复较快,是目前较为恰当的入肝血流阻断方法之一。

Objective:To evaluation the optimum method of hepatictomy by the clinical observation of half-hepatic and full-hepatic blood occlusion for hepatictomy at normal atmospheric temperature.Methods :A retrospective analysis was underwent in126patients with hepatic carci-noma treated with hepatictomy between Mary2000to Mary2001.Resectional surgery was per-formed in patients,37of whom procedured hepatictomy with optional half-hepatic blood occlusion which preclude the ipsilateral hepatic blood and keep the contralateral hepatic blood.While42cases was performed with full-hepatic blood.The effects of blood occlusion on the liver function were evaluated by the analysis of postoperative index of liver function.Differences in various in-dex between groups was assessed and studied statistically.P<0.05is considered significant.Re -sults:There was no operatic mortality.The liver function was recovered to the level of normal or merioperation.Since two weeks postoperatively,94.6%of patients with optional half-hepatic blood occlusion and40.4%of patients with full -hepatic blood occlusion have the recovery of liver function.There was significant difference between them statistically(P<0.05).Conclusion:The method of optional half-hepatic blood occlusion for hepatictomy develops advantages in the effect of liver function and the recovery time.It is considered that this kind of surgery method is an optimum procedure for hepatictomy presently.