巨大肝血管瘤的诊断及手术治疗

Management of Giant Hemangioma of the Liver:Experience in 56 Patients

目的 :探讨肝巨大血管瘤的诊断及术式选择与手术方法。方法 :回顾性分析 5 6例肝巨大血管瘤的临床资料。结果 :B超、CT、MRI诊断肝血管瘤的准确率分别为 93%、91%及 95 %。采用常温下肝门阻断、充分暴露术野、切肝前控制进出血管瘤血管支的方法 ,本组 5 6例肝巨大血管瘤均获安全手术切除 ,其中扩大左右半肝切除 6例 ,左右半肝切除 10例 ,右后叶切除 3例 ,右前叶切除 8例 ,左内叶切除 5例 ,左外叶切除 19例 ,肝血管瘤剥出 5例。效果满意。结论 :B超、CT、MRI等影像技术对肝血管瘤的诊断和鉴别诊断具有重要的价值。良好的暴露 ,切肝前控制进出血管瘤的血管支是保证手术成功。

Objective To explore the diagnosis and treatment in giant hemangioma of the liver.Methods Fifty-six patients with giant hemangioma of the liver from May 1993 to August 2001 were retrospectively reviewed.Results The accurate rates of BUS,CT and MRI in diagnosis for giant hemangioma of the liver were 93%,91% and 95% respectively.All patients underwent resection of giant tumor of the liver safely.The operating method included trisegmentectomy(6),hemihepatectomy(10),right posterior lobectomy(3),right anterior lobectomy(8),left interior lobectomy(5),left lateral lobectomy(19) and tumor enucleation(5).Conclusion BUS,CT and MRI are effective methods in diagnosis of hemangioma of the liver.The outcome of liver resection and enucleation for giant hemangioma is satisfied.Good exposure of the operating field conbined with controlling the vascular entering and going out the tumor may provide optimum safegard for surgical treatment of giant hemangioma of the liver.