基层医院1例肝巨大血管瘤成功切除的经验总结  

Successful resection of a giant liver hemangioma:a case report from one primary hospital

作　　者：侯宝英 赵春选 张伟 Baoying Hou;Chunxuan Zhao;Wei Zhang(Department of General Surgery,Gannan People's Hospital,Gannan 747000,China;Department of Hepatobiliary Oncology,Tianjin Medical University Center Institude and Hospital,Tianjin 300060,China)

机构地区：[1]甘肃省甘南藏族自治州人民医院普外二科,甘肃省甘南州747000 [2]天津医科大学肿瘤医院肝胆肿瘤科

出　　处：《中国肿瘤临床》2020年第19期985-989,共5页Chinese Journal of Clinical Oncology

基　　金：国家科技重大专项子任务项目(编号:2018ZX10723204-007-001);天津市卫健委青年医学新锐项目(编号:2018-2-8);天津医科大学肿瘤医院青年创新人才项目(编号:2017-1-35);天津市教委课题项目(编号:2018JWZD34)资助~~

摘　　要：目的:成人肝血管瘤是最为常见的肝脏良性肿瘤,有伴随症状、血管瘤巨大、血管瘤增长迅速为手术切除指征,现报道肝巨大血管瘤成功施行手术治疗1例。方法:本例肝巨大血管瘤直径达35 cm,重量12.5 kg,应用术前三维可视化技术制定精准手术方案、先行结扎肝右动脉促使血管瘤自体输血、低中心静脉压技术以及先处理流入道后处理流出道的前入路等多项外科技术。结果:按精准肝切除计划手术成功实施,手术时间3 h,患者术后恢复顺利,术后2周出院。术后1个月复查体力及血常规恢复正常。结论:综合应用术前三维可视化技术、低中心静脉压、前入路肝切除及血管瘤自体输血技术切除肝巨大血管瘤是安全可行的。Objective:To report successful surgical resection of a giant hepatic hemangioma.Methods:A giant hepatic hemangioma measured 35 cm in diameter,and the weight was 12.5 kg.Three-dimensional visualization technology was used preoperatively to develop an accurate surgical plan.Several surgical techniques were performed during the operation,including cessation of the right hepatic artery to promote autologous blood transfusion in the hemangioma,maintenance of low central venous pressure to reduce the blood loss,and cessation of the inflow first,followed by the outflow.Results:The operation was successfully performed in 3 hours;intraoperative blood loss was minimal,and the patient recuperated well.Conclusions:By using a preoperative three-dimensional technique and inflow-first approach and by maintaining low venous pressure,a giant hepatic hemangioma can be safely and successfully removed.

关 键 词：肝巨大血管瘤 手术切除 三维可视化 低中心静脉压 自体输血 

分 类 号：R735.7[医药卫生—肿瘤]