解剖分离多肝段联合切除治疗肝脏肿瘤的临床疗效观察  

Clinical Research On Multi-segments Resection of Liver tumor by Anatomic Method of Separation

作　　者：蔡建强[1] 赵平[1] 毕新宇[1] 胡敬群[1] 赵建军[1] 高继东[1] 赵海平[1] 卢清平[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院,100021

出　　处：《实用癌症杂志》2005年第4期380-381,389,共3页The Practical Journal of Cancer

摘　　要：目的探讨解剖分离方法在肝脏肿瘤多肝段联合切除术中的应用及疗效.方法对2001年9月至2003年12月收治的53例肝脏肿瘤患者采用解剖分离方法进行肝段联合切除.结果 53例中,联合2段切除者31例,联合3段切除者20例,联合4段及5段切除者各1例.术中平均出血量285 ml(100～2 000 ml),平均输血量415 ml(200～1 600 ml),其中27例患者未输血.术后无1例发生严重并发症或死亡,并发症发生率为7.54%(4/53).46例肝细胞肝癌中,术后1、2年复发率分别为13.04%(6/46)、23.91%(11/46);病死率分别为6.52%(3/46)、13.04%(6/46),生存率分别为93.47%(43/46)及86.95%(40/46).结论应用解剖分离方法行肝脏肿瘤切除,术中暴露管道清晰,切缘确切安全,术中及术后并发症发生率低,而且疗效肯定,是值得推广的1种肝脏手术方法.Objective To discuss Application and effect of anatomic method of separation on multi-segments resection of liver tumor. Methods During Sep. 2001 to Dec. 2003,53 patients with liver tumor received liver resection by anatomic method of separation for more than 2 segments. Results Among the 53 patients,31 patients underwent 2 segments resection,20 patients underwent 3 segments resection,other 2 patients underwent 4 and 5 segments resection respectively. Average blood loss and blood transfusion was 285 ml （100-2 000 ml） and 415 ml （200-1 600 ml）. 27 patients didn＇t need blood transfusion. The complication rate was 7.54% （4/53） with no serious complication or death. In 46 patients with hepatocellular carcinoma, 1- and 2-year recurrence rate after operation were 13.04% （6/46） and 23.91% （11/46）, 1- and 2-year mortality were 6.52% （3/46） and 13.04% （11/46）. Conclusion Resection of a liver tumor by anatomic method of separation can achieve a good exposure and a safe and clear surgical excision with lower complication. The method is a good surgical procedure for liver resection surgery.

关 键 词：解剖学 外科 治疗 肝肿瘤 

分 类 号：R735.7[医药卫生—肿瘤]