肝海绵状血管瘤108例临床分析  

Clinical Analysis of Hepatic Cavernous Hemangioma (108 Cases Report)

作　　者：黄炽明[1,2] 刘全芳[1,2] 姚远[1,2] 赵刚[1,2] 杜嘉林[1,2] 彭林[1,2] 

机构地区：[1]广东省人民医院 [2]广东省医学科学院血管甲状腺腹壁疝外科,510080

出　　处：《中国现代手术学杂志》2010年第5期324-327,共4页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨肝海绵状血管瘤临床特点及手术治疗的方法与疗效。方法回顾性分析108例肝海绵状血管瘤患者的临床资料,其中34例远离肝门,74例邻近肝门,行肝血管瘤包膜外剥除术34例;行肝切除术74例。74例邻近肝门者中邻近第一肝门30例,第二肝门22例,第三肝门15例,邻近3个肝门者7例。结果远离肝门组术中平均出血量(251.2±112.7)ml,平均阻断时间(20.3±11.8)min,术后发生出血1例(2.9%),胸水2例(5.9%),其临床效果明显优于邻近肝门组(P<0.05或P<0.01),后者的术中出血量为(631.3±233.5)min,平均阻断时间(45.5±25.3)ml,术后出血6例(8.1%),胸水11例(14.9%),胆漏3例(4.1%)。7例邻近第一、二、三肝门的患者,其瘤体直径达(13.5±5.4)cm,术中平均阻断肝门时间(85.4±28.5)min,术中出血量达(1 507.8±228.1)ml,与其他邻近第一肝门、第二肝门及第三肝门三组分别比较,差异显著(P<0.05)。结论手术治疗肝海绵状血管瘤是安全可行的。手术方式首选肝血管瘤包膜外剥离术,对瘤体位于肝实质并累及肝门者可行肝叶或半肝切除术。Objective To study the clinical characteristics and surgical treatment of hepatic cavernous hemangioma.Methods Retrospective analysis of 108 cases of hepatic cavernous hemangioma was performed.There were 34 cases away from the portal,and 74 cases of adjacent hepatic portal in which near the first portal 30 cases,the second portal 22 cases,the third portal 15 cases,and all the 3 portals 7 cases.Hepatic vascular tumor extracapsular cystectomy was undergone in 34 cases;and hepatic resection was used in 74 cases.Results In the 74 cases in the neighborhood from the hepatic portal,and the 34 cases away from the portal,the mean blood loss was（251.2±112.7） ml vs.（631.3±233.5）ml,the average clamp time was（20.3±11.8） minutes vs.（45.5±25.3）minutes,the postoperative complication rate was 2.9%（1/74） vs.8.1%（6/34） of bleeding,5.9%（2/74） vs.14.9%（11/34） of pleural effusion,and 0 vs.4.1%（3/34） of bile leakage respectively,the clinical results was better in the anterior one（P0.05 or P0.01）.In the 7 cases near the first,second and third portal,the tumor diameter was（13.5±5.4）cm,the average intraoperative clamping time was（85.4±28.5） min,blood loss amount was（1 507.8±228.1）ml,which were significantly different from the other three groups（P0.05）.Conclusions Surgical treatment of hepatic cavernous hemangioma is safe and feasible.Hepatic hemangioma capsule cystectomy is the preferred choice,and the liver resection may be suitable for the tumors involved the hepatic portal.

关 键 词：肝肿瘤 血管瘤 海绵状 肝切除术 

分 类 号：R735.7[医药卫生—肿瘤]