选择性半肝血流阻断在肝癌半肝切除术中的应用研究

目的探讨选择性半肝血流阻断在肝癌半肝切除术中的临床价值及安全性。方法将54例行半肝切除术的肝癌患者分为两组：HVC组30例，行选择性半肝血流阻断（HVC法），Pringle组24例，行第一肝门阻断（Pringle法），比较两种方法对术中失血量、手术时间、术后肝功能及并发症发生率等指标的影响。结果两组患者均顺利完成手术。两组失血量、手术时间相比，差异无显著性（P〉0．05）。两组肝功能指标、并发症发生率相比，差异有统计学意义（P〈0．05）。结论肝癌半肝切除术中采用选择性半肝血流阻断能安全有效地控制术中出血．减少术后并发症．有利于术后肝功能的恢复。

Study on application of selective hemihepatic vascular control in hemihepatectomy for hepatoma

Objective] To explore the clinical significance and safety of selective hemihepatic vascular control in hemihepatectomy for hepatoma. Methods] 54 patients with hepatoma who underwent hemihepatectomy were divided into two groups: in group HVC 30 cases underwent hemihepa tic vascular control(HVC) and in group Pringle 24 cases underwent the first hepatic portal control (Pringle). Subsequently, the influence of the two approaches on the parameters including intraoperative blood loss, operative duration, postoperative hepatic function and complications incidence rate was comparatively analyzed. Results] Hemihepatectomy was successfully performed in the two groups. There was no significant difference between the two groups in intraoperative blood loss (P >0.05). Significant difference existed between the two groups in serum alanine transaminase (ALT) (P <0.05). Conclusions] Selective hemihepatic vascular control (HVC) can be applied to control intraoperative bleeding safely and effectively, reduce complications incidence rate and profit the recovery of postoperative hepatic function parameters.