不同肝门阻断方式对肝细胞癌预后的影响  

The influence of different hepatic port blocking methods on the prognosis of hepatocellular carcinoma patients

作　　者：刘建伟 夏勇 武烨晔 马俊永 李锡锋 张小峰 LIU Jian-wei;Xia Yong;Wu Ye-ye(Department of Hepatic Surgery,the Eastern Hepatobiliary Surgery Hospital,Naval Medical University,Shanghai 200438,China)

机构地区：[1]海军军医大学东方肝胆外科医院,上海200438

出　　处：《肝胆外科杂志》2021年第4期265-270,共6页Journal of Hepatobiliary Surgery

基　　金：上海市卫健委课题资助(编号2018BR34)。

摘　　要：目的探讨不同肝门阻断对肝细胞癌(Hepatocellular carcinoma,HCC)患者术后预后的影响。方法选取我院接受肝肿瘤切除术且肝门阻断时间在20~30分钟的274例HCC患者,分为持续性肝门阻断(持续组)和间断性肝门阻断(间断组),比较两组患者预后。结果持续组(n=135)相比间断组(n=139),术后并发症发生率为11.9%vs.20.9%,差异有统计学意义(P=0.044)。围手术期死亡率均为0。术后1、3、5年总体生存率和肿瘤复发率为86.6%、56.8%、30.9%vs.89.2%、62.7%、35.9%和28.1%、61.7%、80.0%vs.28.8%、53.3%、79.3%,差异无统计学意义(P=0.423;P=0.527)。结论肝肿瘤切除术中,阻断时间在20~30分钟的持续性肝门阻断和间断性阻断相比,术后并发症发生率更低,围手术期死亡、总体生存、肿瘤复发率无明显差异。Objective To investigate the influence of different hepatic port blocking methods on the prognosis of hepatocellular carcinoma(HCC)patients.Methods 274 HCC patients who underwent hepatectomy and the hepatic portal block time is 20-30 minutes in our hospital was included.These patients were divided into continuous hepatic portal block(continuous group)and intermittent hepatic portal block(intermittent group)to compare the difference of prognosis.Results The postoperative complications rate of continuous group(n=135)and discontinuous group(n=139)were 16/135(11.9%)and 29/139(20.9%),respectively,which had significant difference(P=0.044).The perioperative mortality rate was 0.The 1-,3-,5-years overall survival rates and tumor recurrence rates of continuous group and discontinuous group were 86.6%,56.8%,30.9%vs.89.2%,62.7%,35.9%and 28.1%,61.7%,80.0%vs.28.8%,53.3%,79.3%,respectively,and the difference was not statistically significant(P=0.423;P=0.527).Conclusion For liver tumor resection with the time of hepatic portal block between 20-30 minutes,continuous hepatic portal block had lower incidence of postoperative complications,similar perioperative death,postoperative overall survival and postoperative recurrence rate compared with intermittent hepatic portal block.

关 键 词：肝门阻断 连续阻断 间歇阻断 预后 

分 类 号：R735.7[医药卫生—肿瘤]