经肝门板半肝阻断技术在肝癌切除中的应用  

Application of hemihepatic blood flow occlusion via portal plate in resection of liver cancer

作　　者：王宗云[1] 黄君[1] 陈祖宜[1] 陆昌友[1] 

机构地区：[1]四川省宜宾市第一人民医院普外科,四川宜宾644000

出　　处：《实用临床医药杂志》2013年第17期51-53,共3页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11321083)

摘　　要：目的探讨经肝门板半肝血流阻断技术在肝癌切除术中的应用价值及安全性。方法根据术中肝脏血流阻断技术不同,将64例行肝癌切除术的患者分为2组,A组患者接受肝门板半肝血流阻断术治疗,B组患者接受Pringle肝门血流阻断术治疗。比较2组患者手术相关情况、术后肝功能及并发症发生情况。结果 A组患者血流阻断总时间显著长于B组,术后住院天数显著短于B组;2组患者术后丙氨酸转氨酶(ALT)、白蛋白(Alb)及总胆红素(TB)水平均较术前出现显著改变,但A组患者以上各指标均于1周内恢复接近至术前水平,且术后1、3、7 d的ALT及TB水平均显著低于B组,Alb水平显著高于B组。2组均未出现死亡患者。结论经肝门板半肝血流阻断技术可有效减轻肝损害,术后肝功能恢复快,且并发症发生率低,是肝癌切除术中较为理想的控制肝脏血流的方式。Objective To investigate the application value and safety of hemihepatic blood flow occlusion via portal plate in resection of liver cancer. Methods According to different hemihep- atic blood flow occlusion techniques during operation, 64 patients performed on the resection of liver cancer were divided into two groups. The patients in group A were treated with hemihepatic blood flow occlusion via portal plate, while those in group B with Pringle hepatic blood flow occlusion. The operation - related conditions, postoperative liver function and complication incidence of pa- tients in two groups were compared. Results The total time of blocking blood flow in group A was significantly longer than that in group B, while the postoperative hospital stays markedly shorter than group B. The levels of postoperative alanine aminotransferase （ALT）, albumin （Alb） and total bilirubin （TB） showed significant changes in patients of two groups compared with treatment be- fore, but the above indicators of patients in group A nearly returned to the preoperative level, and the levels of ALT and TB 1, 3 and 7 days after operation in group A were significantly lower than those in group B, while Alb level significantly higher than group B. There were no deaths in two groups. Conclusion Hemihepatic blood flow occlusion via portal plate can effectively reduce the liv- er damage, promote postoperative recovery of liver function, and has a low incidence of complica- tions. Hence, it is an ideal method to control hepatic blood flow in resection of liver cancer.

关 键 词：肝癌 手术 半肝血流阻断术 Pringle肝门血流阻断术 

分 类 号：R735.7[医药卫生—肿瘤]