选择性阻断Glission鞘入肝血流法在肝癌切除术中的应用  

Clinical application of selective Glisosnean pedicle hepatic vascular exclusion in hepatectomy

作　　者：刘海威[1] 吕峰[1] 张虎[1] 程乐[1] 曹登科[1] 

机构地区：[1]三峡大学仁和医院普外科,湖北宜昌443001

出　　处：《临床外科杂志》2017年第3期186-188,共3页Journal of Clinical Surgery

基　　金：宜昌市科技局研究与开发资助项目(A14301-27)

摘　　要：目的探讨采用选择性阻断Glission鞘入肝血流法(selective Glissonean pedicle exclusion,SGPE)行肝切除术的治疗效果。方法原发性肝癌行肝切除术患者50例,其中行选择性阻断Glission鞘入肝血流法(SGPE组)28例,行第一肝门血流阻断(Pringle组)22例,比较两组患者手术时间、住院时间、术中出血量和术后肝功能。结果与Pringle组比较,SGPE组术中出血量较少[(251.27±43.53)ml比(525.14±90.62)ml],术后丙氨酸氨基转移酶较低,术后前白蛋白较高,术后在院观察时间较短(10天比5天),两组比较差异均有统计学意义(P<0.05);两组手术时间[(109.16±27.33)min比(97.34±10.37)min]、白蛋白水平比较差异无统计学意义(P>0.05)。结论 SGPE组行肝切除术可有效控制出血,术后残肝功能恢复较快。Objective To explore the clinical value of selective Glisosnean pedicle hepatic vascular exclusion in hepatectomy. Methods Fifty patients with primary liver cancer undergoing hepatecto- my were divided into SGPE group （ n = 28 ） and Pringle group （ n = 22 ） undergoing pringle maneuver. The operation time, hospital stays, intraoperative bloodless and postoperative hepatic function were compared betwen two groups. Results Compared with Pringle group,SGPE group had less blood loss[ （251.27 ± 43.53 ） ml比 （ 525.14 ± 90.62） ml ], lower level of glutamic-pyruvic transaminase, higher levels of pre-al- bumin and shorter duration of hospitalization（ 10 days vs 5 days） （ P 〈 0.05 ）. There were no significant deferences in operation time [ （ 109.16 ± 27.33 ） rain vs （97.34 ± 10.37 ） min ] between the two groups （ P 〉 0.05 ）. Conclusion SGPE can effectively control bleeding and improve hepatic function quickly.

关 键 词：原发性肝癌 肝切除术 血流阻断 

分 类 号：R735.7[医药卫生—肿瘤]