选择性入肝血流阻断在合并肝硬化肝癌切除术中的应用  

The application of interruption of hepatic inflow for hepatectomy of liver cancer complicating cirrhosis

作　　者：罗羽宏[1] 温伟军[1] 李宇同[1] 梁忠平[1] 

机构地区：[1]暨南大学附属第一医院外科,广州510630

出　　处：《临床外科杂志》2006年第6期345-347,共3页Journal of Clinical Surgery

基　　金：广东省医学科研基金资助项目(A0312044)

摘　　要：目的探讨原发性肝癌合并肝硬化患者行肝段切除手术中入肝血流阻断方法的更佳选择。方法总结分析合并肝硬化原发性肝癌32例,观察不同入肝血流阻断方法对手术中出血、术后肝功能及患者康复情况的影响。结果全组患者均成功切除肝癌,18例肝门部血流阻断(Pringle法)下的术后有3例患者出现上消化道出血,其中1例死亡;而14例选择性半肝血流阻断无上述情况出现,术后肝功能及腹腔血性引流及康复情况与前者相比,差异有统计学意义。结论合并肝硬化肝癌患者的手术切除,只要注意术前肝功能状况,确定合理的入肝血流阻断及手术方案,手术仍为安全可靠的选择。Objective To discuss the better choice of hepatic inflow blood current interdicting in the segmental resection to the patients of primary hepatocellular carcinoma （PHC） combined cirrhotic. Method Summarized and analysed 32 patients of PHC combined cirrhotic,observed the influence of liver function during and after operation and healing of patients under the different ways of hepatic inflow blood current interdicting. Result All the cases were resected the tumors successfully, 3 of 18 patients which were adopted interdicting hepatic portal （Pringle maneuver） suffered bleeding of the upper alimentary and 1 of the 3 cases was died; 14 patients which were adopted semi- hepatic inflow blood current interdicting had no same result as above, the liver function after operation, blood - red liquid in abdomen and healing aer obvious different between two groups. Conclusion The resection to private hepatoceUular carcinoma （PHC） combined cirrhotic is safe enough if doctor can pay attention to the liver function before operation, confirm the reasonable way of hepatic inflow blood current occlusion and project of operation.

关 键 词：肝癌 肝硬化 肝段切除 肝血流阻断 

分 类 号：R735.7[医药卫生—肿瘤]