肝内亚肝段血流阻断在解剖性肝切除术中的应用研究

目的:探讨肝内亚肝段血流阻断在解剖性肝切除术中的应用。方法:回顾性分析62例肝癌患者的临床资料,其中29例采用肝内亚肝段血流阻断(A组)进行肝切除;33例采用间歇性第一肝门阻断(B组)进行肝切除;对两组术后肝功能及术中出血情况进行比较。结果:A组出现腹水4例,无死亡、腹腔大出血及肝功能衰竭等严重并发症;B组出现腹水5例,肝功能衰竭死亡1例;A组术中出血量、术后第5、9、14 d的血清谷丙转氨酶(alanine transaminase,ALT)明显低于B组,两组比较差异具有统计学意义(P<0.05)。结论:解剖性肝切除时采取肝内亚肝段血流阻断是减少术中出血和术后肝功能迅速恢复的有效的血流阻断方法。

Applied research of intrahepatic subsegmental blood occlusion in the anatomical liver resection

Objective:To investigate the application of intrahepatic subsegmental blood occlusion in the anatomical liver resection.Methods:The clinical data of 62 patients with live cancers,were retrospectively analyzed.The intrahepatic subsegmental blood occlusion method group(group A) included 29 contiguous patients of liver cancer received anatomical hepatectomy while the traditional method group(group B) included 33 patients of liver cancer who received anatomical hepatectomy during the same period;Blood loss during operation and postoperative liver function were compared between these two groups.Results:In group A,4 patients ascites,no mortality and intraabdominal hemorrhage,liver function failure were noted.In group B,5 patients ascites,1 patient experienced liver function failure and died.Blood loss during operation and serum alanine transaminase(ALT) in the postoperative 5th,9th,14th values in group A were significantly lower than those in group B,There is statistical significance between the difference of the two groups(P<0.05).Conclusion:The method of optional intrahepatic subsegmental blood occlusion for anatomical hepatectomy of HCC is one of the effective hepatic blood occlusion methods reducing perioperative blood loss and quickly recovering liver functions.