肝门区域性血流阻断在肝肿瘤切除手术中的应用  

The application value of regional hepatic vascular exclusion in hepatectomy

作　　者：孙万亮 张登勇 马翔[1] 崔培元[1] 吴维[1] 吴斌全[1] 吴华[1] 鲁正[1] SUN Wan-liang;ZHANG Deng-yong;MA Xiang;CUI Pei-yuan;WU Wei;WU Bin-quan;WU Hua;LU Zheng(Department of Hepatobiliary Surgery,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院肝胆外科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2018年第11期1415-1418,共4页Journal of Bengbu Medical College

基　　金：安徽省科技公关项目(1604a0802088)

摘　　要：目的:探讨肝门区域性血流阻断在肝肿瘤切除术中的应用价值。方法:回顾性分析因肝肿瘤行肝切除术54例病人的临床资料,根据术中肝脏血流阻断技术不同,将54例因肝肿瘤行肝切除术病人分为2组,A组24例病人接受肝门区域性血流阻断术治疗,B组30例病人接受Pringle肝门血流阻断术治疗。结果:2组病人手术时间、术中出血量、肝门血流阻断时间和术后24 h腹腔引流量差异均有统计学意义(P <0. 05～P <0. 01)。术后第3、7天,A组丙氨酸氨基转移酶、门冬氨酸氨基转移酶、总胆红素和C反应蛋白水平均低于B组(P <0. 05～P <0. 01)。2组并发症的发生率差异无统计学意义(P> 0. 05)。2组均无围手术期死亡病例。结论:肝门区域性血流阻断技术可明显减少肝肿瘤切除术中的出血量,有效减轻肝功能损害及肝缺血-再灌注损伤,是肝肿瘤切除术中较为合理的控制肝脏出血的方法。Objective： To investigate the application value of regional hepatic vascular exclusion in hepatectomy. Methods： The clinical data of 54 patients treated with hepatectomy were retrospectively analyzed. The patients treated with hepatectomy were divided into the group A（ 24 cases） and group B（ 30 cases） according to the different operation techniques. group A and group B were treated with regional hepatic vascular exclusion and Pringle hepatic vascular exclusion,respectively. Results： The differences of the operation time,intraoperative bleeding,hepatic portal blood flow blocked time and postoperative 24 h peritoneal drainage between two groups were statistically significant（ P〈0. 05 to P〈0. 01）. The difference of the incidence rate of complication between two groups was not statistically significant（ P〉0. 05）. No perioperative death occurred in two groups. Conclusions： The technique of regional hepatic vascular exclusion in hepatectomy can significantly reduce the intraoperative blood loss,liver damage and liver ischemia-reperfusion injury,which is a better way to control blood loss in hepatectomy.

关 键 词：肝肿瘤 肝缺血-再灌注损伤 区域肝血流阻断术 

分 类 号：R735.7[医药卫生—肿瘤]