第一肝门不同阻断方式在精准肝切除中的应用  

Application of Different Blocking Ways at the First Hepatic Portal in Precise Hepatectomy

作　　者：王峻峰[1] 莫一我[1] 王彦坤[1] 孙志为[1] 金焰[1] 张新俊[1] 王军[1] 

机构地区：[1]云南省第一人民医院肝胆外科,云南昆明650032

出　　处：《昆明医科大学学报》2013年第8期51-53,共3页Journal of Kunming Medical University

基　　金：云南省卫生科技计划基金资助项目(2010NS005)

摘　　要：目的探讨不同肝脏血流阻断方法对肝脏手术的手术安全性差异.方法 60例肝切除术患者,按不同肝脏血流阻断方法分组,手术前均进行手术前评估.结果术后第1天Pringle’s法手肝功能ALT平均为(395.0±220.2)U/L,AST平均为(415.3±311.0)U/L;区域性肝脏血流阻断组ALT平均为(110.2士53.0)U/L,AST平均为(125.6±78.5)U/L;肝脏血流不阻断肝脏手术组ALT平均为(98.9士32.2)U/L,AST平均为(96.2±66.5)U/L.术后肝功能损伤比较,Pringle’s组明显大于区域性肝脏血流阻断或肝脏血流不阻断肝脏手术组,差异有统计学意义(P<0.05).结论区域性肝脏血流阻断或肝脏血流不阻断可以减少了术后并发症的发生,同时还适当地扩大了肝切除的适应证.Objective To investigate the differences in the safety of the operation of different hepatic vascular exclusion for liver surgery. Methods Sixty patients with liver resection were grouped by different hepatic blood flow blocking methods, and given pre-operative assessment prior to surgery. Results On the first day after surgery, the average levels of ALT and AST were （395.0 ± 220.2） U/L and （415.3 ± 311.0） U/L in patients who received Pringle＇s method （110.2 ± 53.0 ） U/L and （125.6 ± 78.5） U/L in patients who received regional hepatic vascular exclusion, （98.9 ± 32.2） U/L and （96.2 ± 66.5） U/L in patients who didn＇t receive hepatic vascular exclusion, respectively. Postoperative liver function damage was more serious in patients who received Pringle＇s method than patients who received regional hepatic vascular exclusion or patients who didn＇t receive hepatic vascular exclusion, the difference was statistically significant （P〈0.05） Coflclusion Regional hepatic vascular exclusion or not can not only reduce the incidence of postoperative complications, but also expand the indications for liver resection.

关 键 词：肝脏手术 精准手术 手术安全性 

分 类 号：R657.3[医药卫生—外科学]