不同肝血流阻断方法对外科手术切除原发性大肝癌患者疗效的影响  

Influence of different hepatic blood flow blocking methods on the curative effect of surgical resection of patients with primary massive liver cancer

作　　者：庄盛威 林燕燕 ZHUANG Shengwei;LIN Yanyan(Department of General Surgery,Xiamen Branch,Zhongshan Hospital,Fudan University,Xiamen 361000,China;The Cadre Ward,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350000,China)

机构地区：[1]复旦大学附属中山医院厦门医院普外科,福建厦门361000 [2]福建医科大学附属第一医院干部病房,福建福州350000

出　　处：《中国现代医生》2018年第29期38-40,共3页China Modern Doctor

摘　　要：目的探讨不同肝血流阻断方法对外科手术切除原发性大肝癌患者治疗效果。方法对2015年1月~2017年9月在福建医科大学附属第一医院手术治疗的127例原发性大肝癌患者按照肝血流阻断方法的不同分为肝门阻断组、半肝阻断组和联合阻断组,观察比较三组患者手术指标、肝功能指标及并发症发生情况。结果联合阻断组出血量(342.17±95.52)mL、输血量(181.63±52.96)mL,较肝门阻断组和半肝阻断组明显下降(P<0.05);联合阻断组AST(26.39±5.95)U/L、ALT(49.65±7.64)U/L、TBIL(10.66±2.52)μmol/L,明显低于肝门阻断组和半肝阻断组(P<0.05);三组患者切口感染、胆瘘、胸腹腔积水、肺部感染不良反应发生率比较,无明显差异(P>0.05)。结论外科手术切除原发性大肝癌患者应用联合阻断可有效降低术中失血量,减少输血量,改善肝功能,促进术后康复,值得临床推广应用。Objective To investigate the effect of different hepatic blood flow blocking methods on surgical resection ofpatients with primary massive liver cancer. Methods A total of 127 patients with primary hepatocellular carcinoma whounderwent surgical treatment at the First Affiliated Hospital of Fujian Medical University from January 2015 to September 2017 were divided into hepatic portal occlusion group, half liver block group and combined occlusion group according to different methods of hepatic blood flow interruption. The surgical indexes, liver function and complications of thethree groups were compared. Results The amount of bleeding（342.17±95.52） mL and blood transfusion （181.63±52.96） mLin the combined occlusion group were significantly lower than those in the hepatic portal occlusion group and half liverblock group （P〈0.05）. The AST （26.39±5.95） U/L, ALT （49.65±7.64） U/L, TBIL （10.66±2.52） μmol/L in the combinedocclusion group were significantly lower than those of the hepatic occlusion group and the half liver block group （P〈0.05）.There was no significant difference in the incidence of infection, biliary fistula, hydrothorax and pulmonary infection,and pulmonary infection （P〉0.05）. Conclusion The combined blockade in surgical resection of primary large liver cancer can effectively reduce intraoperative blood loss, reduce blood transfusion, improve liver function, and promote postoperative rehabilitation. It is worthy of clinical application.

关 键 词：肝门阻断 半肝阻断 联合阻断 原发性大肝癌 外科手术 

分 类 号：R735.7[医药卫生—肿瘤]