肝静脉根部及肝后下腔静脉损伤的处理方法  

Management of injuries to the roots of hepatic veins and retrohepatic vena cava

作　　者：王铁功[1] 刘汝海[1] 李凤山[1] 张执全[1] 杨冬山[1] 张磊[1] 陈新[1] 雷豹[1] 董家鸿[2] 

机构地区：[1]沧州市中心医院肝普外一科,061001 [2]北京市解放军总医院肝胆外科

出　　处：《中华肝胆外科杂志》2013年第7期499-502,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨肝静脉根部及肝后下腔静脉损伤救治的有效方法。方法2006年1月1日至2012年12月31日我们相继处理了6例此类型损伤，针对肝静脉根部及肝后下腔静脉损伤部位的不同采用不同的手术切口及全肝血流阻断方法。同时复习国内外处理此类型损伤的治疗方法。结果6例患者中3例死亡，其中术中死亡2例，术后死亡1例，存活3例。对于肝静脉根部及肝后下腔静脉损伤虽然有一些显露和止血的方法，但此类损伤的病死率仍难以降低。肝静脉根部及肝后下腔静脉损伤仍然是外科医生的巨大挑战。结论“便捷的创伤部位显露”以及“快速有效的止血”是手术成功的关键。经典开腹手术和血管介入技术的结合或许可为此类损伤的救治打开一道新的大门。Objective To study the effective veins and retrohepatic vena cava （RHC）. Methods methods to treat injuries to the roots of hepatic From January 1, 2006 to December 31, 2012, we treated 6 cases with injuries to the roots of hepatic veins and RHC. Different approaches and methods were used to achieve hepatic vascular exclusion （HVE） according to the sites of the injuries. We also reviewed the experience reported in the medical literature. Results Of 6 patients, 2 died intraopera- tively, 1 died postoperatively, 3 patients survived. Although there are effective methods to treat inju ries to the roots of hepatic veins and RHC, the for surgeons to treat these injuries. Conclusions mortality rate is still high. It is still a major challenge Adequate exposure of the injured site and rapid and effective control of bleeding are the keys to success. The combined use of open surgery and vascular interventional techniques may open a new approach to deal with these injuries in the future.

关 键 词：损伤 肝静脉 肝后下腔静脉 全肝血流阻断 

分 类 号：R657.3[医药卫生—外科学]