| 傅庆洋,陈建峰,陈铁江.不同肝血流阻断方法在肝癌伴肝硬化患者肝切除手术中应用分析[J].浙江中西医结合杂志,2016,26(11): |
| 不同肝血流阻断方法在肝癌伴肝硬化患者肝切除手术中应用分析 |
| Effect comparison of different ways of hepatic vascular exclusion on hepatectomy of patients with hepatocellular carcinoma and cirrhosis |
| 投稿时间：2016-03-29 修订日期：2016-08-12 |
| DOI： |
| 中文关键词: 肝血流阻断 肝癌 肝脏功能 肝切除术 |
| 英文关键词:Hepatic vascular exclusion Hepatocellular carcinoma hepatic function Hepatectomy |
| 基金项目:浙江省医药卫生一般研究计划项目 |
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| 中文摘要: |
| 摘要 目的 比较肝癌伴肝硬化患者在肝切除术中应用不同的肝血流阻断方法的应用效果。方法 以2013年8月-2015年8月在我院行肝切除术的80例肝癌伴肝硬化的患者为研究对象，根据不同的肝血流阻断方法分为半肝入肝血流阻断组38例和全肝入肝血流阻断组42例。观察两组患者手术时间，术中出血量，术后住院时间。记录术后患者的血清谷草转氨酶（AST）、谷丙转氨酶（ALT）等肝功指标以及术后并发症的情况。结果 两组患者（半肝入肝血流组VS 全肝入肝血流组）手术时间（148±42 VS 142±34）、术中出血量（563±53 VS 547±23）、术后住院时间（12.7±5.1 VS 11.3±4.3）差均不具有统计学意义，P>0.05。术后7天，肝功指标（半肝入肝血流组VS 全肝入肝血流组）血清谷草转氨酶AST（77.81±9.08 VS 213.82±61.37）、血清谷丙转氨酶ALT（65.72±12.11 VS 197.40±56.28），P<0.05，差异均具有统计学意义两组患者术后并发症发生率：半肝入肝血流组7.9% 全肝入肝血流组28.6%, P<0.05，差异具有统计学意义。结论 在肝癌伴肝硬化患者的肝切除术中，半肝入肝血流阻断法与全肝入肝血流阻断法相比，有降低患者术后并发症发生的风险，肝脏功能恢复较快等优势，值得在临床上推广。 |
| 英文摘要: |
| Abstract Objective To compare the application effect of half hepatic vascular occlusion and Pringle maneuver in hepatectomy of patients with hepatocellular carcinoma and cirrhosis. Methods From August 2013 to August 2015 in Department of Hepatobiliary Surgery of our hospital, 80 patients with hepatocellular carcinoma and cirrhosis undergoing hepatectomy were selected.According to ways of hepatic vascular exclusion ,we divided 80 patients into two groups: half hepatic vascular occlusion group with 38 cases and Pringle maneuver group with 42 cases.The hepatic vascular exclusion time, intraoperative blood loss and postoperative hospital stay of two groups were observed, the serum alanine aminotransferase (ALT), aspartate amino transferase (AST) in the two groups were recorded, and the conditions of postoperative complications were compared. Result half hepatic vascular occlusion group compared the hepatic vascular exclusion time, intraoperative blood loss and postoperative hospital stay with Pringle maneuver group :hepatic vascular exclusion time (148±42 VS 142±34) min,intraoperative blood loss (563±53 VS 547±23)mL,intraoperative blood los s(12.7±5.1 VS 11.3±4.3)d,the differences were not statistically significant (P > 0.05). The hepatic function index of two groups were compared,the levels of ALT(65.72±12.11) U/L,AST(77.81±9.08 )U/L in half hepatic vascular occlusion group were lower than Pringle maneuver group ALT (197.40±56.28)U/L,AST(213.82±61.37)U/L .the differences were statistically significant (P <0.05).The incidence of complications in half hepatic vascular occlusion group is 7.9% ,the incidence of complications in Pringle maneuver group is 28.6% the differences were statistically significant (P <0.05). Conclusion Half hepatic vascular occlusion in hepatectomy of patients with hepatocellular carcinoma and cirrhosis is useful to promote the recovery of hepatic function,and the complications are less, which is worthy of clinical promotion and application. |
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