第二肝门部肝癌切除合并主肝静脉结扎对门静脉压力的影响  

The effects of hepatoectomy combined with major hepatic venous ligation on the portal vein pressure in patients with second hepatic door cancer

作　　者：王在国[1] 刘光中[1] 丁福全[1] 张爱玲[1] 付永嵘[1] 

机构地区：[1]四川省肿瘤医院外科,成都610041

出　　处：《中华实验外科杂志》1999年第2期150-152,共3页Chinese Journal of Experimental Surgery

基　　金：四川省卫生厅科研基金!No.982006

摘　　要：探讨第二肝门部肝癌切除合并主肝静脉结扎对自由门静脉压力（ＦＰＰ）的影响。方法在肝切除术前将埋植式给药装置（ＩＤＤＳ）置入门静脉主干，并通过ＩＤＤＳ对１０例病人之肝切除前后及术后１、３、５、７、１４、２１、２８天的ＦＰＰ进行直接动态测量。结果全组病人肝切除后均发生ＦＰＰ升高，以术后３～７天最为显著，之后逐渐下降；ＦＰＰ升高的幅度与肝硬化程度、肝切除范围、主肝静脉结扎情况之间存在密切联系；３例术后ＦＰＰ≥３５ｃｍＨ２Ｏ病人中，２例并发上消化道出血。结论第二肝门部肝癌切除合并主肝静脉结扎将导致ＦＰＰ的一过性升高，ＦＰＰ的升高是术后消化道出血的重要因素。Objective To investigate the effects of hepatoectomy combined with major hepatic venousligation on free portal pressure (FPP) in patients with second hepatic door cancer. Mathod The FPP beforeand after hepatoectomy and 1, 3, 5, 7, 14, 21, 28 days after operation was directly and dynamically measuredthrough implantable drug delivery system (IDDS) which was inserted into portal vein and implanted under theskin of abdominal wall during peration in 10 patients with second hepatic door cancer. Result FPP had a reversible increase after hepatoectomy. The absence of cirrhosis, extent of liver resection and major hepatic venous ligation were significantly correlated with the amplitude of FPP elevation. Two out of 3 patients withFPP≥35 cm H2O after operation were associated withupper gastrointestinal bleeding. Conclusion The second hepatic door cancer resection combined with major hepatic venous ligation would led to a reversible increaseof FPP, which was the key factors for postoperative gastrointestinal bleeding.

关 键 词：肝肿瘤 肝切除术 肝静脉结扎术 血流动力学 

分 类 号：R735.7[医药卫生—肿瘤]