解剖性肝叶切除术在肝胆外科中的临床研究  

Clinical research on anatomic hepalobectomy in hepatobiliary surgery

作　　者：祁夫魁[1] 陈平[2] 马宽生[3] 李德福[1] 朱静[1] 俆国宏 

机构地区：[1]四川省眉山市人民医院普外科,眉山620000 [2]第三军医大学大坪医院肝胆外科 [3]第三军医大学西南医院肝胆外科

出　　处：《肝胆外科杂志》2013年第6期435-438,共4页Journal of Hepatobiliary Surgery

摘　　要：目的探讨肝叶切除术采用第一肝门阻断法(Pringle法)和解剖性肝叶阻断两种阻断技术各自对肝脏血生化指标、手术时间、出血量、住院时间的影响。方法对采用第一肝门阻断法(Pringle法)、解剖性肝叶阻断法,共30例肝叶切除病例的临床资料进行回顾性分析,分析不同的肝血流阻断对肝脏血生化指标(AST,ALT,ALB,TBIL)、手术时间、术中出血量、住院时间的影响。结果术后均出现肝功能酶学指标不同程度升高,以第一肝门阻断肝脏血生化升高较解剖性阻断明显,经统计分析,于术后3天两者有差异(P<0.05)。解剖性肝叶切除较第一肝门阻断术中出血量少,术后恢复快,住院时间短,经统计分析,两者有统计学差异(P<0.05)。结论解剖性肝叶切除术,术中出血量减少,避免了肝脏缺血再灌注损伤,术中肝损伤小,术后肝脏功能恢复快,在保证患者安全,降低患者住院时间,节约患者住院费用等方面有着明显优势,有着良好的经济和社会效益.Objective To explore and compare the effects on the serum biochemical indexes, duration of operations, amount of bleeding and hospital stays of the patients by respectively applying Pringle maneuver and anatomic hepalobectomy. Methods Con- ducted retrospective analysis on the clinical data of 30 hepalobectomy cases treated with either Pringle or anatomic hepalobectomy, ana- lyzed the differences of blood biochemical indicators-AST, ALT, ALB and TBIL, duration of operations, amount of bleeding and hospital stays of the patients treated with different hepatic vascular exclusions. Result In all cases the liver function enzymological results showed high level in the different degree after operation, and with significant higher level in cases using Pringle maneuver than those treated with anatomic hepalobectomy. By statistical analysis, the differences reached P 〈 0.05 on the third day post operation ; The ca- ses using anatomic hepalobectomy showed less amount of bleeding, quicker recovery and shorter hospital stays than those using Pringle maneuver. The differences were P 〈 0.05 by statistical analysis. Conclusion Anatomic hepalobectomy showed significant advantages with less amount of bleeding in surgery, better protection to the liver from ischemia - reperfusion injury, quicker liver function recovery after surgery, safer surgerical proccession for the patients, reduced patients＇ hospital stays, reduced the cost of hospitalization for the patients and therefore brings favorable economic and social benefits.

关 键 词：解剖性 肝叶切除 

分 类 号：R575[医药卫生—消化系统]