保留半肝动脉血供联合肝缺血预处理在肝硬化复杂肝切除术中的应用

目的:探讨减轻肝硬化患者复杂肝切除缺血再灌注损伤的措施。方法:回顾性分析46例肝硬化患者复杂肝切除术中保留半肝动脉血供入肝血流阻断+肝缺血预处理(实验组)的临床资料,并与同期全肝入肝血流阻断(Pringle法)肝切除术61例(对照组)作对比研究。结果:实验组平均阻断时间(38.75±6.2)min,对照组(21.67±4.60)min,2组差异有统计学意义(P<0.05)。2组术后3、7和15d血清谷丙转氨酶(ALT)、术后3d血清总胆红素及术中、术后出血量差异无统计学意义(P>0.05)。结论:保留半肝动脉血供入肝血流阻断+肝缺血预处理技术对减少肝硬化患者复杂肝切除术后肝衰竭的发生有重要意义。

Application of retention half-hepatic artery and hepatic vascular exclusion combine liver ischemic preconditioning in cirrhosis patients who were implemented complex hepatectomy

Objective： To explore procedures to reduce liver ischemia-reperfusion injury in patients with cirrhosis who were suffered complex hepatectomy. Methods： Retrospectively reviewed 46 patients with cirrhosis in our hospital who were suffered complex hepatectomy with half-hepatic vessel occusion and liver ischemic preconditioning（experimental gorup） . Another 61 cases of hepatectomy of total hepatic inflow occlusion（pringle method） also studied as the control group. Results： Everage occusion time was（38.75±6.2） min in experimental group and（21.67±4.60） min in control group. But there were no significant difference in alanine aminotransferase（ALT） 3 d,7 d,and5 d after operation between two groups.Similiarly,blood loss during operation seems no statistical difference between two groups（P0.05） . Conclusions： Retention half-hepatic artery and hepatic vascular exclusion combine liver ischemic preconditioning in cirrhosis patients who were implemented complex hepatectomy is significance to reduce the incidence of postoperative liver failure.