选择性门静脉染色联合肝叶血流阻断在右叶解剖性肝切除中的应用  

Application of selective portal vein staining combined with hepatic lobe blood fl ow obstruction in right lobe anatomical hepatectomy

作　　者：陈海敏 朱庆胜 Chen Haimin;Zhu Qingsheng(Hepatobiliary Surgery Department of Yuebei People’s Hospital,Guangdong Shaoguan 512000,China)

机构地区：[1]粤北人民医院肝胆外科,广东韶关512000

出　　处：《临床普外科电子杂志》2025年第1期16-20,共5页Journal of General Surgery for Clinicians(Electronic Version)

基　　金：韶关市卫生健康科研项目(Y22010)。

摘　　要：目的探讨肝叶血流阻断联合选择性门静脉染色在右叶解剖性肝切除中的应用效果。方法研究对象为2022年1月至2023年10月于粤北人民医院行右叶解剖性肝切除的82例患者,按随机数字表法分为两组,试验组和对照组各41例,试验组采取肝叶血流阻断,对照组采取第一肝门阻断法Pringle法,均进行门静脉染色,比较两组的治疗效果。结果两组患者的手术时间无显著差异(P>0.05),但试验组住院时间短于对照组,术中出血量少于对照组,差异均有显著性(P<0.05)。术前,两组患者的肝功能指标无显著差异(P>0.05);术后,试验组总白蛋白水平高于对照组,总胆红素和谷丙转氨酶水平低于对照组,差异均有显著性(P<0.05)。两组患者术后胆汁漏、出血、感染发生率无明显差异(P>0.05),但试验组肝静脉损伤发生率低于对照组,且随访6个月,复发率低于对照组,差异均有显著性(P<0.05)。结论肝叶血流阻断联合门静脉染色在右叶解剖性肝切除中能够减少术中出血,降低术后并发症发生率,是一种安全可行的治疗方法。Objective To investigate the application eff ect of hepatic lobe blood fl ow obstruction combined with selective portal vein staining in right lobe anatomical liver resection.Method The research subjects were 82 patients who underwent right lobe anatomical liver resection at Yuebei People’s Hospital from January 2022 to October 2023.They were randomly divided into two groups,an experimental group and a control group,with 41 pa-tients in each group.The experimental group received hepatic lobe blood fl ow obstruction,while the control group received the Pringle method of fi rst porta hepatis obstruction.Portal vein staining was performed in both groups to compare the therapeutic eff ects.Result There was no signifi cant diff erence in surgical time between the two groups of patients(P>0.05),but the experimental group had a shorter hospital stay and less intraoperative bleeding than the control group,with signifi cant diff erences(P<0.05).Before surgery,there was no signifi cant diff erence in liver function indicators between the two groups of patients(P>0.05);After surgery,the total albumin level in the experimental group was higher than that in the control group,and the total bilirubin and alanine aminotransferase levels were lower than those in the control group,with signifi cant diff erences(P<0.05).There was no signifi cant diff erence in the incidence of postoperative bile leakage,bleeding,and infection between the two groups of patients(P>0.05),but the incidence of hepatic vein injury in the experimental group was lower than that in the control group,and the recurrence rate was lower than that in the control group after 6 months of follow-up,with signifi cant diff erences(P<0.05).Conclusion The combination of hepatic lobe blood fl ow obstruction and portal vein stain-ing can reduce intraoperative bleeding and lower the incidence of postoperative complications in right lobe anatomical liver resection.It is a safe and feasible treatment method.

关 键 词：右叶 肝解剖肝切除 肝叶血流阻断 门静脉染色 第一肝门阻断法Pringle法 

分 类 号：R657.3[医药卫生—外科学]