肝脏部分切除手术中全入肝血流阻断联合半肝血流阻断的临床研究  

Clinical study of total hepatic flow blockade combined with hemihepatic blood flow blockade during partial hepatic resection

作　　者：何华日 夏旺宁 唐彪 HE Huari;XIAWangning;TANG Biao(Department of Hepatobiliary,Pancreatic and Spleen Surgery,Yongzhou Central Hospital,Yongzhou,Hu'nan,425100,China)

机构地区：[1]永州市中心医院肝胆胰脾外科,湖南永州425100

出　　处：《当代医学》2023年第14期159-162,共4页Contemporary Medicine

摘　　要：目的探讨肝脏部分切除手术中全入肝血流阻断(Pringle)联合半肝血流阻断的临床疗效。方法选取2019年1月至2020年12月本院收治82例肝脏部分切除手术患者作为研究对象,随机分为对照组与观察组,各41例。对照组采用接受Pringle术,观察组在对照组基础上联合半肝血流阻断术,比较两组围手术期指标、不同时间点肝功能指标、并发症发生率。结果两组手术时间比较差异无统计学意义;观察组肠道功能恢复时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。两组丙氨酸氨基转移酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)水平组间、时间、交互比较差异有统计学意义(P<0.05)。组内比较:术后3、5 d,两组ALT、AST、TBIL水平均高于术前1 d,术后5 d,两组ALT、AST、TBIL水平均低于术后3 d,差异有统计学意义(P<0.05)。组间比较:术前1 d,两组ALT、AST、TBIL水平比较差异无统计学意义;术后3、5 d,观察组ALT、AST、TBIL水平均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论Pringle术联合半肝血流阻断术应用于肝脏部分切除术中,可减少患者术中出血量、缩短其住院时间、改善患者术后肝功能指标,安全性较高,值得临床推广应用。Objective To investigate the clinical efficacy of total hepatic flow blockade(Pringle)combined with hemihepatic blood flow blockade during partial hepatic resection.Methods 82 patients with partial hepatic resection treated in our hospital from January 2019 to December 2020 were selected as the study subjects,and they were randomly divided into the control group and the observation group,with 41 cases in each group.The control group received Pringle operation,and the observation group was combined with hemihepatic blood flow blockade on the basis of the control group,the perioperative indicators,liver function indicators at different time points,and the incidence of complications were compared between the two groups.Results There was no significant difference in operation time between the two groups;the time of intestinal function recovery and hospital stay in the observation group were shorter than the control group,and the amount of intraoperative blood loss was less than the control group,the differences were statistically significant(P<0.05).There were significant differences of the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL)between two groups of group,time points and interaction(P<0.05).Comparison within the group:At 3 and 5 d after operation,the levels of ALT,AST and TBIL in the two groups were higher than those at 1 day before operation,and at 5 d after operation,the levels of ALT,AST,and TBIL of the two groups were lower than at 3 d after operation,and the differences were statistically significant(P<0.05).Comparison between groups:At 1 d before operation,there were no significant differences in ALT,AST,and TBIL levels between the two groups;the levels of ALT AST and TBIL in the observation group were lower than the control group 3 and 5 d after operation,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The application of Pringle combine

关 键 词：肝脏部分切除手术 全入肝血流阻断 半肝血流阻断 

分 类 号：R575[医药卫生—消化系统]