肝血管瘤手术方式的探讨

目的探讨肝海绵状血管瘤的外科手术方式。方法本组70例,其中45例行包膜外剥脱术,25例行肝叶切除或不规则肝部分切除。切肝时采用入肝血流阻断。结果 70例中48例出血量在400～500ml以下,其中25例出血量非常少而未输血,15例出血量400～500ml,7例出血量〉500ml;45例行包膜外剥脱术者出血量均在400～500ml以下,且术后肝功恢复较肝叶切除或不规则肝部分切除者为好。所有病理检查均为海绵状血管瘤。结论肝血管瘤包膜外剥脱术肝损伤轻,出血少,患者恢复快,近、远期疗效好;如肝血管瘤存在包膜则包膜外剥脱术可考虑为手术治疗肝血管瘤的首选术式。切肝时采用入肝血流阻断,肝内解剖清晰,出血量少,可施行一系列高难度肝切除手术。

Evaluation of the hepatic cavernous hemangioma surgical procedure

Objective To evaluate the hepatic cavernous hemangioma surgical procedure.Methods 70 patients,45 regular capsule endarterectomy,25 regular or irregular hepatectomy liver resection.Hepatectomy with hepatic inflow occlusion time.Results 70 cases,48 cases of bleeding in the 400～500ml these,25 cases very small amount of bleeding without blood transfusion,15 cases of bleeding 400～500ml,7 cases with hemorrhagic greater than 500ml;45 capsular stripping routine bleeding patients who are within the 400～500ml less,and postoperative liver function recovery compared with irregular liver lobectomy or partial resection is better.All pathological examination were cavernous hemangioma.Conclusion The capsule of the liver hemangioma liver injury endarterectomy light,less bleeding,faster recovery of patients,short and long term good effect;such as hemangiomas exist outside the capsule is coated endarterectomy may be considered for surgical treatment of hepatic hemangioma operation of first choice.Hepatectomy with hepatic inflow occlusion time,liver anatomy clear,less blood loss,can be implemented a series of difficult liver resection.