肝切除术后并发症分析

目的总结和探讨肝切除术后常见并发症及其防治经验。方法回顾性分析73例肝切除术后患者的围手术期并发症,其中原发性肝癌28例,肝内胆管结石15例,胆管癌12例,胆囊癌2例,血管瘤5例,肝外伤7例,肝囊肿4例。Ch ild-Pugh肝功能分级A级59例,B级14例。行左半肝切除12例,单纯左肝外叶切除10例,左外叶切除+右肝肿瘤挖除6例,右半肝切除6例,右肝三叶切除2例,其他肝叶肝段不规则切除21例,肝楔形切除或肿块挖除16例。结果术后并发症包括腹腔内出血5例、肝功能衰竭6例、腹腔感染3例、肺部感染与胸腔积液4例、胆汁漏2例及上消化道出血2例。1例死亡,死因为术后肝功能衰竭、上消化道出血。肝脏恶性肿瘤患者术后并发症发生率虽高于肝脏良性疾病患者(38.1%vs.19.4%),但无统计学差异(P>0.05)。结论术前详细评估患者肝功能储备及相应心肺功能情况,提高手术技巧,加强术后管理是防治肝切除术后并发症的关键因素。

Complication Analysis for the Hepatectomy

Objective To summarize the common complications after hepatectomy and explore the prevention experiences.Methods Clinical results were retrospectively analyzed in the 73 cases of hepatectomy,including 28 of primary liver cancer,15 of hepatolithiasis,12 of biliary duct cancer,2 of gallbladder carcinoma,5 of liver hemangioma,7 of liver injury and 4 of hepatic cysts.There were 12 cases underwent left liver resection,10 underwent simple left lateral lobectomy,6 of left lateral lobectomy plus right tumor mass ex...