不阻断肝门肝切除术在肝癌治疗临床应用研究  

Clinical research of liver resection without hepatic blood inflow occlusion in treatment of liver cancer

作　　者：黄继超[1] 夏华平 姜德清[1] 柯群刚[1] 樊继泷[1] 郝占伟[1] 

机构地区：[1]江苏省连云港市第二人民医院肝胆外科,江苏连云港222006 [2]芜湖军分区第一离职干部休养所卫生所,安徽芜湖241000

出　　处：《中国医药科学》2016年第18期165-167,224,共4页China Medicine And Pharmacy

摘　　要：目的探讨肝癌采用不阻断肝门切除术治疗临床效果。方法选取2011年6月～2016年6月连云港市第二人民医院肝胆外科行肝切除术的原发性肝癌患者41例，随机分为肝门阻断组（阻断组）21例和不阻断肝门组（不阻断组）20例，阻断组术中采用全肝入肝血流阻断，不阻断组术中不阻断入肝血流，比较两组临床资料。结果两组术中出血量、手术时间差异无统计学意义（P〉0．05）。术后住院时间不阻断组明显少于阻断组（P〈0．05）。两组术前白蛋白（ALB）、总胆红素（TBIL）及谷丙转氨酶（ALT）均差异无统计学意义（P〉0．05），而术后1d及7d阻断组TBIL、ALT均显著高于不阻断组，ALB显著低于不阻断组，有统计学差异（P〈0．05）。阻断组并发症发生率为38．1％，而不阻断组为5％，明显低于阻断组（P〈0．05）。结论采用不阻断肝门肝切除治疗肝癌具有一定的安全性和可行性，减少了对肝功能的影响，降低了术后并发症发生率，相对安全可靠，可操作性强，值得在临床推广应用。Objective To investigate clinical effect of non-blocking hepatic resection in treatment of liver cancer. Methods 41 cases of primary liver cancer carried on liver resection in Department of Hepatobiliary Surgery of Lianyungang Second People＇ s Hospital from June 2011 to June 2016 were selected and randomly divided into blocking hepatic portal group （blocking group） with 21 eases and non-blocking hepatic portal group （non-blocking group） with 20 cases. Liver blood flow was used in blocking group during the operation, and liver blood flow was not blocking＇up in non＇blocking group during operation. Clinical data of the two groups were compared. Results There was no difference in average amount of bleeding and operation duration （P〉0.05）. Hospital time of non-blocking group were obviously fewer than that of blocking group （P〈0.05）.There were no significantly statistical differences in preoperative albumin （ALB）, total bilirubin （TBIL） and alanine aminotransferase （ALT） between the two groups（P〉0.05）, while the TBIL and ALT of blocking group was higher than thao of non-blocking group on postoperative ld and 7 d,but the ALB of block group was higher than that of non-blocking group,and it is significantly different （P 〈 0.05）. The complication rate of blocking group was 38.1%, which was significantly higher than that of non-blocking group （5%）（P 〈 0.05）. Conclusion Hepatectomy for primary liver cancer without blocking hepatic portal has certain safety and feasibility. It can reduce the influence on liver function and decrease the incidence of postoperative complication. The case shows that the technique with relative safety and reliability was suitable for operation, and it is worth to be spread and clinical application.

关 键 词：肝门阻断 肝切除 肝癌 肝功能及并发症 

分 类 号：R657.3[医药卫生—外科学]