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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 investigate the safety and feasibility of selective hepatic blood flow blockade hepatectomy. Methods A retrospective analysis of 65 patients undergoing liver resection in our hospital from March 2002 to October 2006 was divided into selective hepatic artery occlusion (HVC, n=28) and primary hepatic occlusion (Pringle, n=37); Comparison of intraoperative blood loss, operation time, postoperative liver function recovery, average drainage volume and postoperative complications were compared between the two groups. Results There was no significant difference in intraoperative blood loss and operation time between the two groups. Serum alanine aminotransferase levels in the HVC group were significantly lower than those in the Pringle group at 3 days and 7 days after operation. The mean drainage volume in the HVC group was significantly less than 2 days after operation. There were two cases of liver failure in the Pringle group; one of them died, and there was no liver failure and death in the HVC group. Conclusion Selective hepatic blood flow blockade hepatectomy is safe and feasible. Compared with the first hepatic hilum obstruction, hepatic function recovery is more conducive to the reduction of hepatic failure.