肝切除术在肝脏良性肿瘤治疗中的价值  

Value of hepatectomy in treatment of benign liver tumors

作　　者：彭淑牖[1] 陈晓鹏[1] 彭承宏[1] 吴育连[1] 刘颖斌[1] 江献川[1] 徐斌[1] 史留斌[1] 白明东[1] 沈宏伟[1] 

机构地区：[1]浙江大学医学院附属第二医院外科,杭州市310009

出　　处：《中华肝胆外科杂志》2002年第7期390-392,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的　探讨肝切除术治疗肝脏良性肿瘤 (benignlivertumors,BLT)的价值及其特点。方法　回顾性分析我院 1994年 1月至 2 0 0 1年 6月用肝切除术治疗的 37例肝脏良性肿瘤病人的临床资料 ,其中肝海绵状血管瘤 2 9例 ,肝细胞腺瘤、右肝错构瘤和肝脏平滑肌瘤各 2例 ,右肝上皮样血管内皮瘤和肝脏局灶性结节性增生各 1例。结果　全组共行各种肝叶切除术 2 6例 (左外叶切除 15例、右后叶切除或部分切除 5例、右半肝切除 3例、右前叶部分切除 2例、左半肝切除 1例 ) ,瘤体局部切除术 11例。 9例术中预置全肝血流阻断带 ,2例应用自体血回输。 3例术后分别发生右侧胸腔积液、切口和膈下感染等并发症。无手术死亡 ,37例全部治愈。结论　对于多数有症状、体积较大或怀疑恶变之肝脏良性肿瘤 ,肝切除术是主要的治疗手段 ,而且安全有效 ;借助术中或术后病理检查可明确诊断 ;术中应用全肝血流阻断和自体血回输可提高困难手术的安全性 。Objective To explore the value of hepatectomy in treatment of benign liver tumors (BLT). Methods The clinical data of 39 patients with BLT treated with hepatectomy in our hospital from January 1994 to June 2001 were retrospectively analyzed. Of the patients, 29 were with hepatic cavernous hemangioma (HCH) and the 8 with hepatocellular adenoma (HA), leiomyoma, focal nodular hyperplasia (FNH) and epithelioid hemangioendothelioma (EH). Results Various kinds of liver lobectomy was performed in 26 patients while local resection of tumor region in other 11. Occluding clamps around total blood flow were applied in 9 patients before hepatectomy and autotransfusion in 2 during operation. Postoperative complications including pleural effusion, wound and subphrenic infections were developed in 3 patients. All the 37 patients were cured. Conclusions For most of BLT patients with symptoms or doubted malignancy, hepatectomy is the major therapeutic method because of its advantages of high safety and good effect. Meanwhile, complete hepatic vascular occlusion and autotransfusion can improve the safety of hepatectomy.

关 键 词：肝肿瘤 肝切除术 肝细胞腺瘤 局灶性结节性增生 

分 类 号：R735.7[医药卫生—肿瘤] R730.56[医药卫生—临床医学]