肝切除术在肝脏疾病治疗中的价值

目的探讨肝切除术治疗肝脏疾病的价值及其特点.方法回顾分析该院1992～2003年用肝切除术治疗272例肝脏疾病的临床资料.探讨了原发性肝癌、肝血管瘤、肝内胆管结石的手术适应证、手术方法、术中控制出血及围手术期处理等问题.结果手术后并发症发生率为22.22%,手术死亡率为2.00%,其中原发性肝癌185例,术后1、3和5 a生存率分别为83.32%、45.87%和18.43%.结论肝切除术后并发症发生率较高,术中控制出血及肝切除量,减少手术时间是降低术后并发症和死亡率的关键.术中应用全肝血流阻断扣自体血回输可提高困难手术的安全性.

Vale of hepatectomy in treatment of liver diseases

To explore the value of hepatectomy in treatment of live diseases. The clinical data of 272 patients with live diseases0 treated with hepatectomy in our hospital from 1992 to2003 were retrospectively analyzed. The present study is aimed to explore the incidence of hepatectomy, the method of surgical procedure and the management of pre and postoperation with primary liver cancer and liver angioma and intrahepatiocbile duct stone. The complication rate was 22.00% after the operation, the death rate was 2.00%. Of them 185 cases from primary liver cancer,the overall 1, 3, 5, years survival rate was 83.32%, 45.87%, 18.43% respectively. [Conclusions] Though hepatectomy may result in a relatively high overall morbidity. Decreasing blood loss, controlling the volume for hepatectomy and reducing operative duration are crucial for decreasing the morbidity and mortality. Meanwhile, complete hepatic vascular occlusion and autotransfusion can improve the safety of hepatectomy.