中国普通外科杂志Issue(1)：18-22,5.DOI:10.3978/j.issn.1005-6947.2015.01.004
大肝癌手术切除术中不同肝血流阻断方法的临床研究
Comparison of different hepatic inflow occlusion methods in hepatectomy for large liver cancer
张贯启 1张志伟 1项帅 1涂振霄 1杨磊 1陈孝平1
作者信息
- 1. 华中科技大学附属同济医院肝脏外科中心，湖北武汉430030
- 折叠
摘要
Abstract
Objective:To compare the clinical effcacies of three hepatic inlfow occlusion methods in hepatectomy for large hepatocellular carcinoma. <br> Methods:The clinical data of 218 patients undergoing hepatectomy for large hepatocellular carcinoma (>5 cm) from January 2011 to March 2013 were retrospectively analyzed. During surgery, 88 cases were subjected to intermittent hepatic inflow occlusion with Pringle maneuver (portal occlusion group), 51 cases underwent selective hemihepatic blood flow occlusion (hemihepatic occlusion group), and 79 cases received infrahepatic inferior vena cava (IVC) clamping plus Pringle maneuver (combination occlusion group). hTe relevant clinical variables among the three groups of patients were compared. <br> Results:There were no significant differences in preoperative conditions, operative time, inflow occlusion time and liver resection volume among the three groups (all P>0.05). In either hemihepatic occlusion group or combination occlusion group, the intraoperative blood loss, blood transfusion volume and blood transfusion rate were all significantly lower than those in portal occlusion group, and the blood transfusion volume and blood transfusion rate in combination occlusion group were also signiifcantly lower than those in hemihepatic occlusion group (all P<0.05). All liver function parameters showed no significant difference among the three groups on postoperative day (POD) one, but the transaminase and total bilirubin levels in both hemihepatic occlusion group and combination group were signiifcantly decreased compared with portal occlusion group on POD 3 and 7 (all P<0.05). No signiifcant difference was noted in incidence of postoperative complications among the three groups (P>0.05). <br> Conclusion:In large liver cancer resection, hepatic inlfow control with combination of infrahepatic IVC clamping and Pringle maneuver can not only effectively reduce intraoperative blood loss, but also be advantageous for recovery of postoperative liver function.关键词
肝肿瘤/外科学/肝切除术/方法Key words
Liver Neoplasms/surg/Hepatectomy/method分类
医药卫生引用本文复制引用
张贯启,张志伟,项帅,涂振霄,杨磊,陈孝平..大肝癌手术切除术中不同肝血流阻断方法的临床研究[J].中国普通外科杂志,2015,(1):18-22,5.
