前入路绕肝提拉法半肝切除术的临床效果分析  

Analysis of clinical efficacy of hemihepatectomy using the anterior approach with liver hanging maneuver

作　　者：熊伟[1,2] 李富宇[1] 温尔刚[2] 俞小炯[2] 董科[2] 

机构地区：[1]四川大学华西医院肝胆外科,四川成都610041 [2]四川省医学科学院.四川省人民医院肝胆外科,四川成都610072

出　　处：《实用医院临床杂志》2015年第1期107-109,共3页Practical Journal of Clinical Medicine

基　　金：四川省卫生厅医学科研基金(编号:070091)

摘　　要：目的探讨前入路绕肝提拉法半肝切除的临床实用性和安全性。方法 48例行半肝切除术的患者中,前入路绕肝提拉法半肝切除(前入路组)与传统路径半肝切除(传统路径组)各一半。比较两组术中失血量、手术时间、术后肝功能、住院时间及并发症发生率等指标。结果两组均顺利完成手术,手术时间、并发症比较差异无统计学意义(P>0.05);前入路组术中失血量、血浆引流量、住院时间均少于传统路径组,术后3天和7天肝功能指标优于传统路径组,差异有统计学意义(P<0.05)。结论前入路绕肝提拉法半肝切除是安全实用的,更符合肿瘤手术的无瘤原则,较传统术式出血更少,利于术后肝功能恢复,能最大限度保护剩余肝脏的功能,有利于患者康复,值得临床应用推广。Objective To investigate the operation safety and clinics significance of hemihepatectomy using anterior approach with liver hanging maneuver.Methods Forty-eight patients undergoing hemihepatectomy were divided into two groups,24 in each group.Group A received the anterior approach with liver hanging maneuver while group B received the traditional path.The amount of intraoperative bleeding,time of operation,postoperative liver function,liver function recovering,and complications were compared be-tween the two groups.Results All operations were performed smoothly.There was no difference in the time of operation between two groups.The amount of intraoperative bleeding,plasma volume during operation,time in the hospital and complications in the group A were less than that in the group B.The liver function indexes such as ALT,AST and TB after 3 and 7 days of operation in the group A were better than that in the group B（all P〈0.05）.Conclusion The anterior approach with liver hanging maneuver is safe and practi-cal.It is more in line with the principle of tumor disease-free of tumor operation.It also has advantages of less bleeding than traditional surgery that is beneficial for the recovery of postoperative liver function,maximizes the protection of residual liver function,and thus is conducive to the rehabilitation of patients.Therefore,it is worthy of clinical application.

关 键 词：前入路 绕肝提拉法 半肝切除 

分 类 号：R737.7[医药卫生—肿瘤] R61[医药卫生—临床医学]