重视肝切除的核心策略:血流控制和切面确定  

The core strategies of hepatectomy: blood control technique and hepatectomy plane determination

作　　者：刘荣[1] 刘渠[1] Liu Rong;Liu Qu(Second Department of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853,China)

机构地区：[1]解放军总医院肝胆外二科全军肝胆外科研究所,北京100853

出　　处：《中华外科杂志》2019年第7期500-502,共3页Chinese Journal of Surgery

摘　　要：选择恰当的出血控制技术和确定断肝平面是肝切除手术的核心技术环节,不仅关系到手术的顺利实施,更能够影响患者的预后。预先控制拟切除肝脏的血管,用防止出血的风险预先控制理念代替术中止血的传统理念能够有效控制肝切除术中出血。综合应用缺血线引导、术中超声定位技术、目标肝段门静脉染色技术、荧光染色技术、循肝静脉技术及三维可视化技术有助于在术中准确判定拟切除肝脏边界并引导手术断肝平面。Blood control technology and determination of hepatectomy plane are the core techniques of liver resection, which not only affect the operative performance, but also affect the prognosis of patients.The concept of pre-control the blood vessels in the hepatic segment which should be resected can effective control of bleeding during hepatectomy.A comprehensive application of the ischemic line guidance, the intraoperative ultrasound, the segmental portal staining, fluorescent staining, the hepatic vein-oriented technique, and three-dimensional technique are helpful to precisely determine the boundary of hepatic segment to be resected and guide the hepatectomy plane.

关 键 词：肝切除术 解剖 出血控制 切除平面 手术入路 

分 类 号：R657.3[医药卫生—外科学]