肝血流阻断方法的研究现状  

Research Status of Hepatic Blood Occlusion Techniques

作　　者：闫威[1] 张嘉越[1] 

机构地区：[1]中国人民解放军第三○三医院普外科,南宁530021

出　　处：《医学综述》2014年第22期4131-4133,共3页Medical Recapitulate

摘　　要：目前肝切除术仍是治疗肝肿瘤的主要方法,肝脏中血管分布复杂,血供丰富,在手术中如何有效地控制出血是影响手术结果的重要因素,也是影响术后并发症及病死率的重要因素。为了减少肝切除术中出血和避免手术风险,目前仍在不断研究各种肝切除术的血流阻断方法。Pringle法是最早应用于肝切除术中,也是目前临床应用最广泛的一种方法,但是时间不宜过长;全肝血流阻断可以很好地控制失血量,但易引发缺血/再灌注损伤;半肝脏血流阻断方法减轻了肝脏缺血再灌注损伤,但只能应用于半肝患者;实施肝门血流阻断是肝脏手术中一项重要技术。合理、正确地选用一种既有较好止血效果又能减少因阻断引发的肝脏损伤的肝血流阻断方法,仍需深入研究和探讨。Hepatectomy is still the main method for treatment of liver tumor. How to effectively control the bleeding in surgery is an important factor affecting the surgical result,which is also an important factor influencing the postoperative complications and disease mortality. In order to reduce the bleeding of the patients during operation and avoid the risk of surgery,studies on variious hepatic blood occlusion methods are still going on. Pringles maneuver is firstly used in the liver resection,which is also the most widely clinical application,but the time should not be too long. Total hepatic vascular exclusion can well control the blood loss,but it may easily produce ischemic-reperfusion injury; hemihepatic vascular occlusion technique can reduce the severity of visceral congestion and total liver ischemia,but it is only for hemihepatectomy. Selecting suitable hepatic blood occlusion methods based on the situation of the patient can reduce blood loss in hepatectomy and ensure the patient＇s safety,where further study is still needed.

关 键 词：肝血流阻断 肝切除术 肝肿瘤 

分 类 号：R657.3[医药卫生—外科学]