选择性与Pringle法血流阻断在原发性肝癌切除术中应用效果对比  

Comparison of the effect of selective and Pringle blood flow blockade in the resection of primary liver cancer

作　　者：候建永 李治锋 刘小庆 Hou Jianyong;Li Zhifeng;Liu Xiaoqing(The989th Hospital of the Joint Support Force of the Chinese People′s Liberation Ar-my,Luoyang,Henan471000)

机构地区：[1]中国人民解放军联勤保障部队第九八九医院,河南洛阳471000

出　　处：《辽宁医学杂志》2023年第1期34-37,共4页Medical Journal of Liaoning

摘　　要：目的 探讨选择性与Pringle法血流阻断在原发性肝癌切除术中应用效果。方法 回顾性分析76例原发性肝癌患者的病例资料,按肝门血流阻断方式不同将患者分为选择组(采用选择性入肝血流阻断,n=37)和Pringle组(采用Pringle法血流阻断,n=39)。比较两组术中出血量、手术时间及住院时间,比较两组术前、术后1d、术后5d丙氨酸氨基酸转氨酶(ALT)、谷丙转氨酶(AST)等肝功能指标及术后并发症发生情况。结果 Pringle组患者术中出血量多于选择组(P<0.05),手术时间、住院时间长于选择组(P<0.05);整体分析发现,ALT、AST组间比较、时间点比较及交互作用差异均有统计学意义(P<0.05);组内比较:两组手术后1d ALT、AST高于手术前、手术后5d(P<0.05),两组手术后5d ALT、AST高于手术前,低于手术后1d(P<0.05);组间比较:选择组手术后1d、5d ALT、AST低于Pringle组(P<0.05);两组术后并发症发生率无统计学差异(P>0.05)。结论 相比于Pringle法血流阻断,选择性血流阻断对肝癌患者肝功能损伤更小,且手术时间更短、出血量更少,术后恢复更快,临床应用效果更理想。Objective To explore the effect of selective and Pringle blood flow blockade in the resection of primary liver cancer.Methods The case data of 76 patients with primary liver cancer were retrospectively analyzed, and the patients were divided into a selection group(using selective hepatic blood flow occlusion, n=37)and a Pringle group(using Pringle Method blood flow is blocked, n=39).The intraoperative blood loss, operation time and hospital stay were compared between the two groups.The liver function indexes such as alanine amino acid transaminase(ALT)and alanine aminotransferase(AST)and postoperative complications were compared between the two groups before operation, 1 day after operation, and 5 days after operation.Symptoms.Results Patients in the Pringle group had more intraoperative blood loss than the selection group(P<0.05),and the operation time and hospital stay were longer than those in the selection group(P<0.05).The overall analysis found that the comparison between ALT and AST groups, time point comparison and interaction differences were statistically significant(P<0.05).Intra-group comparison: ALT and AST on the 1st day after the operation were higher than those before and 5 days after the operation(P<0.05).The ALT and AST on the 5th day after the operation were higher than those before the operation and lower than the 1 day after the operation(P<0.05).Comparison between groups: The ALT and AST of the selected group were lower than those of the Pringle group on the 1st and 5th day after surgery(P<0.05).There was no statistical difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Compared with Pringle blood flow blockade, selective blood flow blockade has less damage to liver function in patients with liver cancer, and has shorter operation time, less bleeding, faster postoperative recovery, and better clinical application effects.

关 键 词：肝癌 开腹肝切除术 血流阻断 

分 类 号：R735.7[医药卫生—肿瘤]