选择性肝血流阻断法在肝切除术中应用研究

目的探讨选择性肝血流阻断法行肝切除术的治疗效果。方法原发性肝癌行肝切除术患者60例，其中行选择性肝血流阻断法肝切除术28例（选择性肝血流阻断组），行全肝入肝血流阻断法肝切除术32例（全肝血流阻断组），比较2组手术时间、术中出血量、术后肝功能、并发症及预后情况。结果与全肝血流阻断组比较，选择性肝血流阻断组术中出血量较少、术后谷丙转氨酶较低，术后前白蛋白及胆碱酯酶水平较高、术后并发症发生率较低、术后在院观察时间较短，2组比较差异均有统计学意义（P〈0．05）；2组手术时间、胆红素及白蛋白水平比较差异无统计学意义（P〉0．05）；选择性肝血流阻断组并发症发生率（7．1％）低于全肝血流阻断组（28．1％）（P〈0．05）。结论选择性肝血流阻断法行肝切除术可有效控制出血，术后肝功能恢复较快。

Clinical application of selective hepatic vascular exclusion in hepatectomy

Objective To explore the clinical value of selective hepatic vascular exclusion （SHVE） to hepatectomy. Methods Sixty patients with primary liver cancer undergoing hepatectomy were divided into SHVE group （n = 28） undergoing SHVE and Pringle group （n= 32） undergoing Pringle maneuver. The operation time, intraoperative blood loss, postoperative hepatic function, complications and prognosis were compared between two groups. Results Compared with Pringle group, SHVE group had less blood loss, lower level of glutamic-pyruvic transaminase, higher levels of prealbumin and cholinesterase, lower incidence of complications, and shorter duration of hospitalization （P〈0.05）. The incidence of complications was 7.1% in SHVE group, lowere than that in pringle group （28.1%）（P〈0.05）. There were no significant differences in operation time, total bilirubin or albumin levels between two groups （P 〉 0.05）. Conclusions SHVE can effectively control bleeding and improve hepatic function.