肝癌切除时肝血流阻断方法的选择

目的 探讨肝癌患者行肝切除术时肝血流阻断方法的选择。方法 观察分析65例肝癌患者行肝切除术时选用不同的肝血流阻断对手术及患者术后恢复的影响。结果 65例肝癌患者中行常规肝门阻断16例,选择性半肝血流阻断26例,肝内双向血流阻断22例,全肝血流阻断1例。全部患者肿瘤均获完整切除,除1例死亡外,其余术后恢复良好。结论 肝切除时肝血流阻断方法的选用应根据病变的位置、范围大小及手术类型和肝硬化程序等因素综合考虑而定。选择性半肝血流阻断法更适用于肝硬化病人的肝切除。

Choice of methods of the hepatic vascular occlusion for resection of liver cancer

Objective To investigate the choice of different method of hepatic vascular occlusion for re-section of liver cancer. Methods 65 cases of liver cancer were resected with 4 kinds of different hepatic vascular occlusion. The operative courses, the duration and type of hepatic vascular occlusion and the variation of postop-erative liver function were analvzed retrospectivelv. Results Among 65 patients, 16 cases were performed routine Pringle's maneuver, 26 cases were performed selective hemihepatic vascular oclusion, 22 cases were performed intrahepatic vascular occlusion. total hepatic vascular occlusion was done in l case. The tumor of all patients were removed in intact and only one patient died, other patients recovered completely after operation. Conclusion The choice of hepatic vascular occlusion depends on the location, size of liver cancer, type of operation and degree of liver cirrhosis. Selective semihepatic vascular occlusion in hepatectomy is more suitable to those patients with liver cirrhosis.