二期肝切除治疗原发性肝癌的临床分析

本文对２５例在介入治疗基础上行二期肝切除术的中晚期原发性肝癌病例（Ｒ２组）与４６例仅行一期肝切除术的中晚期原发性肝癌病例（Ｒ１组）进行了临床分析比较，结果手术平均耗时Ｒ２组３．５，小时＞Ｒ１组２．６小时（Ｐ＜０．０５），术中平均失血量Ｒ２组２６００ｍｌ，Ｒ１组１５００ｍｌ（Ｐ＜０．０１），Ｒ２组手术死亡４例（１６％）。Ｒ１组无手术死亡（Ｐ＜０．０５），Ｒ２组术后肝功能指标的恢复明显长于Ｒ１组（Ｐ＜０．０５）。因此强调对中晚期肝癌应争取作二期切除．先行介入治疗作为前期治疗，而后行二期切除不宜提倡，确实不能行一期切除者，方考虑在充分估价病人肝功能的代偿能力和储备功能的基础上有选择地进行二期肝切除。

Clinical analysis of two-stage hepatectomy for advanced primary hepatocellular carcinoma

In 25 cases of primary hepatocellular carcinoma,the two-stage hepatectomy was performed after interventional therapy (R2),and 46 cases of the same disease underwent the liver resection without any other therapy before operation (R1),Comparison between R2 and R1 recealed longer operationg period (3. 5 hr vs 2. 6 hr),larger bleeding (2600ml vs 1500ml), higher operative mortality (16% vs 0%)and longer reinstage mental period of liver function after the operation These results indicate that the liver resection without other pretreatment should be the first therapy of choice in treating advanced primary hepatoma and the two-stage hepatectomy should selectively becused depending upon the assessment of the liver function and the hepatic function reserve.