目的

探讨选择性肝血流阻断肝切除术的安全性和可行性。

方法

回顾性分析我院2002年3月至2006年10月行肝切除术65例,分为选择性肝血流阻断组(HVC,n=28)和第一肝门阻断组(Pringle,n=37);比较两组病人术中出血量、手术时间、术后肝功能的恢复、术后两天的平均引流量以及术后并发症。

结果

两组病人术中出血量和手术时间均无显著性差异;HVC组术后3天和7天的血清谷丙转氨酶明显低于Pringle组,术后2天的平均引流量HVC组明显少于Pringle组;Pringle组有两例出现肝功能衰竭,其中1例死亡,HVC组没有肝功能衰竭及死亡病例。

结论

选择性肝血流阻断肝切除术安全、可行,较第一肝门阻断更有利于肝功能的恢复,减少肝功能衰竭的发生。

Objective

To explore the safety and feasibility of selective hepatic vascular control in hepatectomy.

Methods

The data of 65 cases of hepatectomy in our hospital from 2002.03 to 2006.10 were analyzed retrospectively,including a group of selective hepatic vascular control(HVC,n=28)and a group of Pringle's maneuver(Pringle,n=37).The operative bleeding volume,operative time,the recovery of postoperative liver function,mean drainage volume of two postoperative days and postoperative complication were compared between the two groups.

Results

There were no significant differences between the two groups in operative bleeding volume and operative time.Serum ALT value of the third and the seventh postoperative days in HVC group was significantly lower than that of the Pringle group.The mean drainage volume of the first two days in HVC group was significantly less than that of the Pringle group.There were 2 cases of liver failure in Pringle group and one of them died.No liver failure and death were found in HVC group.

Conclusion

Selective hepatic vascular control is safe and feasible in hepatectomy.It helps more to the recovery of liver function than the Pringle's maneuver.It can also reduce the occurance of liver failure.