肝血流阻断分步再灌注肝切除术的临床研究

目的　探讨一种在肝切除术中控制肝血流的新方法。　方法　通过改进肝切除时肝血流的阻断方法 ,对比分析观察组和对照组的切肝失血量、术后肝功能损伤等指标。　结果　观察组门静脉阻断时间为 ( 4 1± 12 )min ,切肝失血量为 ( 117± 79)ml,术后血清转氨酶为 ( 192± 12 6 ) μ L ,血清胆红素为 ( 195± 71) μmol L ,血清丙二醛 (MDA)为 ( 1.90 2± 0 .78) μmol L ;对照组全肝门阻断时间 ( 2 3± 9)min ,切肝失血量 ( 30 3± 2 72 )ml,术后血清转氨酶、胆红素和MDA分别为( 336± 193) μ L、( 10 0± 74) μmol L和 ( 2 .774± 0 .732 ) μmol L ,两组间比较有显著性差异。　 结论　分步再灌注肝血流阻断法能较长时间地控制肝血流 ,明显减少肝切除过程中的失血量 ,且对肝功能损伤较轻。

The Clinical Study of Hepatectomies with Hepatic Blood Occlusion and Intemittent Re-infusion

Objective To investigate a new method of controlling the hepatic blood flow in hepatectomy. Method Comparing the study group and the control group on the blood loss during hepatectomy and the hepatic functional damage after the operation. Results The blood loss and the serum aminotransferase values were signficanly lower in the study group than that in the control group (P<0.05), but the serum bilirubin levels showed no difference (P>0.05). Conclusion Hepatic blood occlusion and intermittent re-infusion can control the blood flow in longer time without serious damage to the hepatic function after the operation, thus make the operation to go easy and reduce the morbidity markedly.