选择性半肝血流阻断在大肝癌切除术中的应用  

Selective hemihepatic vascular occlusion in hepatectomy for large hepatocellular carcinomas

作　　者：黄涛[1] 周进学[1] 杨楠木[1] 

机构地区：[1]河南省肿瘤医院肝胆外科,河南郑州450000

出　　处：《中国普通外科杂志》2010年第7期787-789,共3页China Journal of General Surgery

摘　　要：目的探讨选择性半肝血流阻断方法在大肝癌切除术中的临床意义。方法回顾性分析近3年来40例大肝癌切除术患者的临床资料,40例术中均采用选择性阻断肿瘤侧半肝入肝血流和出肝血流的方法。结果 40例大肝癌切除均顺利完成。术中出血量100～800 mL,平均360 mL。25例术中未输血。手术时间90～150 min,平均116 min;术后恢复良好并痊愈出院,无肝功能衰竭及其他严重并发症,无围手术期死亡。结论选择性半肝血流阻断是一种安全有效的肝血流阻断方法,其具有控制出血确切、肝功能损害小、避免肠黏膜屏障损伤、防止空气栓塞和肿瘤播散转移的优点,适用于合并肝硬化的大肝癌或巨大肝癌的切除。Objective To evaluate the clinical values of selective hemihepatic vascular occlusion in hepatectomy for large hepatocellular carcinomas.Methods Forty patients with large hepatocellular carcinomas who underwent hepatectomy with selective hepatic inflow and outflow occlusion of tumor-bearing liver were retrospectively analyzed.Results All the 40 patients underwent hepatectomy successfully.The blood losts during the operation was 100-800 mL（average 360 mL）.The operation time was 90-150 min（average 116 min）.Intraoperative blood transfusion was not performed in twenty-five patients.All patients recovered completely and were discharged without liver function failure or other severe complications.There was no perioperative death.Conclusions Selective hemihepatic vascular occlusion in hepatectomy for large hepatocellular carcinomas is a safe and effective method with advantages of controlling hemorrhage,decreasing liver damage and gut barrier injury,avoiding air embolism and preventing metastasis.

关 键 词：肝肿瘤/外科学 半肝血流阻断 肝切除术/方法 

分 类 号：R735.7[医药卫生—肿瘤]