选择性半肝血流阻断在大肝癌切除术中的应用
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黄涛 E-mail:hbht68@163.com

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Selective hemihepatic vascular occlusion in hepatectomy for large hepatocellular carcinomas
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    摘要:

    目的:探讨选择性半肝血流阻断方法在大肝癌切除术中的临床意义。
    方法:回顾性分析近3年来40例大肝癌切除术患者的临床资料,40例术中均采用选择性阻断肿瘤侧半肝入肝血流和出肝血流的方法。
    结果:40例大肝癌切除均顺利完成。术中出血量100~800 mL,平均360 mL。25例术中未输血。手术时间90~150 min,平均116 min;术后恢复良好并痊愈出院,无肝功能衰竭及其他严重并发症,无围手术期死亡。
    结论:选择性半肝血流阻断是一种安全有效的肝血流阻断方法,其具有控制出血确切、肝功能损害小、避免肠黏膜屏障损伤、防止空气栓塞和肿瘤播散转移的优点,适用于合并肝硬化的大肝癌或巨大肝癌的切除。

    Abstract:

    Objective:To evaluate the clinical values of selective hemihepatic vascular occlusion in hepatectomy for large hepatocellular carcinomas.
    Methods:Forty patients with large hepatocellular carcinomas who underwent hepatectomy with selective hepatic inflow and outflow occlusion of tumor-bearing liver were retrospectively analyzed.
    Results:All the 40 patients underwent hepatectomy successfully. The blood losts during the operation was 100-800 mL (average 360 mL). The operation time was 90-150 min(average 116 min). Intraoperative blood transfusion was not performed in twenty-five patients. All patients recovered completely and were discharged without liver function failure or other severe complications. There was no perioperative death.
    Conclusions:Selective  hemihepatic vascular occlusion in hepatectomy for large hepatocellular carcinomas is a safe and effective method with advantages of controlling hemorrhage,  decreasing liver damage and gut barrier injury, avoiding air embolism and preventing metastasis.

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黄涛|周进学|杨楠木.选择性半肝血流阻断在大肝癌切除术中的应用[J].中国普通外科杂志,2010,19(7):787-789.
DOI:10.7659/j. issn.1005-6947.2010.07.016

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  • 收稿日期:2009-06-24
  • 最后修改日期:2010-02-23
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  • 在线发布日期: 2010-07-15