半肝血流完全阻断对肝癌切除术中肿瘤播散的有效性研究  

Effectiveness of Hemihepatic Vascular Control on Prevention of Tumor Spread in Hepatectomy

作　　者：萨其日拉图 

机构地区：[1]内蒙古自治区人民医院,010010

出　　处：《实用癌症杂志》2015年第11期1704-1706,共3页The Practical Journal of Cancer

摘　　要：目的研究半肝血流完全阻断预防肝癌切除术中肿瘤播散的有效性。方法选取120例HCC患者为研究对象,随机分为Pringle组与HCV组各60例,对照组采用Pringle法,观察组采用HCV法。术后规则随访3年,记录两组患者的术中情况（包括手术时间、术中出血量、阻断次数及阻断时间）及术后的肝内复发率与肝外转移情况,并对组间差异进行分析比较。结果两组手术时间、术中出血量及阻断时间相比均无显著性差异（P〉0.05）;HCV组60例均1次阻断成功,Pringle组阻断1次者48例,阻断2次者7例,阻断3次者5例,组间比较差异具有统计学意义（P〈0.05）。HCV组术后1~3年内的肺转移率分别为8.3%、15.0%与35.0%,Pringle组分别为18.3%、26.7%与43.3%,两组术后1年内肺转移率存在显著性差异,Pringle组高于HCV组,2、3年内肺转移率组间比较未见显著性差异（P〉0.05）。结论应用半肝血流完全阻断法行肝脏切除术,可有效减少术后早期肿瘤肝内复发及肺转移的发生。Objective To study the effectiveness of hemihepatic vascular control（HVC） on prevention of tumor spread in hepatectomy. Methods 120 cases of patients with hepatocellular carcinoma （HCC） were divided into Pringle group and HVC group, each with 60 cases. The control group was given Pringle, while the observation group was given HCV. Implement regular fol- low up for 3 years to all subjects,intraoperative conditions （including operative time, blood loss, block number, and block time） and postoperative intrahepatie reecurence rate and extrahepatic metastasis were recorded. Differences between the 2 groups were compared. Results There had no significant differences between the 2 groups in operative time, blood loss, and block time （ P 〉 0.05 ） ;60 cases in HCV group were successfully blocked once ,48 cases in Pringle group were blocked once ,7 cases were blocked twice, and 5 cases were blocked three times. The difference was statistically significant （ P 〈 0.05 ）. The postoperative 1-3 year pulmonary metastasis rate of HCV group were 8.3% , 15.0%, and 35.0% , while in Pringle group were 18.3% , 26.7% , and 43.3%. The difference between the 2 groups was significant, 1-year pulmonary metastasis rate in Pringle group was higher than HCV group, there had no significant difference between the 2 groups in 2-, 3-year pulmonary metastasis rate （P 〉 0.05 ）. Conclu- sion HCV in hepatectomy can effectively reduce early postoperative intrahepatic recurrence and metastasis of lung cancer.

关 键 词：半肝血流完全阻断 肝癌切除术 肿瘤播散 

分 类 号：R735.7[医药卫生—肿瘤]