腹腔镜肝叶切除的术中血流控制与止血  

Blood Flow Control and Hemostasis in Laparoscopic Hepatectomy

作　　者：左芝 成伟[1] 尹新民[1] 蒋波[1] ZUO Zhi CHENG Wei YIN Xin-min et al.(Department of Hepatobiliary Surgery, Hunan Provincial People＇s Hospital, Changsha 410005, China)

机构地区：[1]湖南省人民医院肝胆外科,湖南长沙410005

出　　处：《医学与哲学（B）》2017年第6期63-66,共4页Medicine & Philosophy(B)

基　　金：2016年湖南省医药卫生科研项目(B2016004);2017年湖南省自然科学基金立项(2017JJ2159)

摘　　要：控制术中出血是顺利完成手术的先决条件,尤其在肝切除术这种需要面对一个富血脏器的手术。腹腔镜下处理出血困难的特性决定了腹腔镜肝切除的出血预防和处理是手术的重中之重。本文基于腹腔镜手术的特点,从血流控制、断肝止血和维持中心静脉压与腹腔内压平衡三个方面讨论腹腔镜肝叶切除中预防和处理出血的临床问题。选用合理的血流控制手段、合适的断肝器械和方法、熟练的肝脏离断手技、维持中心静脉压与腹腔内压平衡,能够减少腹腔镜肝切除术中出血,保证手术安全。The intraoperative control of bleeding is a prerequisite for successful completion of surgery,especially in liver resection,in which the surgeon would face a blood rich organ.The difficulty of laparoscopic treatment of bleeding is the most important factor in laparoscopic hepatectomy.In this paper,based on the characteristics of laparoscopic surgery,prevention and treatment of bleeding in laparoscopic hepatectomy were discussed from three aspects of blood flow control,liver resection and balance of central venous pressure and pneumoperitoneum pressure.Reasonable selection of flow control method,instrument and method suitable for liver transection,skilled manipulation,maintain balance of central venous pressure and pneumoperitoneum pressure,which can reduce bleeding in laparoscopic hepatectomy,ensure the safety of patient.

关 键 词：腹腔镜肝切除 止血 血流控制 

分 类 号：R615[医药卫生—外科学]