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1.
目的:探讨微波固化在肝硬化肝癌不规则性肝切除术中的应用价值。方法:回顾性分析第四军医大学唐都医院普外科2011年1月-2013年4月行不规则性肝切除肝硬化肝癌患者158例的临床资料,其中男性96例,女性62例,年龄32-65岁(47.7±9.4)。乙型肝炎后肝硬化58例,酒精性肝硬化21例。肝功能分级:Child-Pugh A级116例,B级42例。不规则性肝切除组(Ⅰ组)77例,微波固化+不规则性肝切除组(Ⅱ组)81例,两组在性别构成、年龄、肝炎病史、肝癌病史、门静脉高压症、AFP、PLT、Child-Pugh评分、肝功能(白蛋白、谷丙转氨酶、总胆红素、凝血酶原时间)等无显著差异(P0.05)。比较分析两组术中肝门阻断、出血量、输血量、手术时间、术后肝功能恢复及术后并发症的发生率情况。结果:微波固化+不规则性肝切除术组无肝门阻断,且在手术时间、出血量、补血量、补液量、住院时间、术后住院时间明显少于不规则性肝切除术组(P0.05)。而在淋巴结清扫数目、围手术期死亡率无显著差异(P0.05)。在术后1天、3天和7天时,两组在白蛋白、总胆红素、凝血时间无显著差异(P0.05),术后1天、3天谷丙转氨酶无显著差异(P0.05),术后7天时Ⅱ组较Ⅰ组恢复快(P0.05)。Ⅱ组术后并发症发生率明显少于Ⅰ组。结论:微波固化在不规则性肝切除术中无需行肝门阻断,具有出血少、输血少、手术时间短、术后住院时间短等优点。微波固化联合不规则性肝切除术在肝硬化肝癌中具有良好效果。  相似文献   

2.
目的:探讨丹参酮ⅡA磺酸钠注射液对行肝门阻断术患者血流动力学及血液流变学影响。方法:选取我院肝胆外科收治的原发性肝癌患者92例,随机数字表达法分为2组,其中对照组46例,全麻行肝癌根治术治疗;实验组46例,在手术前7 d予以丹参酮ⅡA磺酸钠注射液,80 mg注入150 m L 0.9%氯化钠注射液中,日一次静滴,连续治疗7 d。分别观察两组患者肝门阻断前及阻断后1 min,5 min,10 min,20 min和解除阻断后30 min血流动力学及血液流变学。结果:1实验组患者肝门阻断后10 min和阻断20 min两个时间段的心率(Heart rate,HR)明显低于对照组同时间段HR,平均动脉压(Mean arterial pressure,MAP)、心排出量(Cardiac output,CO)、左室做功指数(The left ventricular work index,LCWI)明显高于对照组同时间段,差异有统计学意义(P0.05)。2实验组患者肝门阻断后10 min和阻断20 min两个时间段的全血高切粘度、全血低切粘度、血浆比粘度和纤维蛋白定量明显低于对照组同时间段,差异有统计学意义(P0.05)。结论:丹参酮ⅡA磺酸钠注射液能够明显改善肝门阻断术引起的血流动力学及血液流变学各项指标,从而保证原发性肝癌手术过程中肝脏的供血量,防止血液凝聚导致的血栓形成。  相似文献   

3.
目的:探究选择性入肝血流阻断(SPVE 法)在肝癌合并门脉高压手术中的临床应用效果。方法:选择我院2009 年10 月 ~2014 年10 月期间确诊为肝癌合并门脉高压的患者80 例,按照随机数字数表法分为观察组和对照组各40 例,观察组行SPVE 法进行血流阻断,对照组行全入肝血流阻断法(Pringle 法)进行血流阻断。对比两组手术时间、阻断血流时间、手术中出血量、输血 量、手术前后患者肝功能相关指标及术后并发症发生率。结果:两组手术时间和血流阻断时间对比差异无统计学意义(P>0.05),而 观察组术中出血量及输血量均小于对照组,差异具有统计学意义(P<0.05);术后观察组血液中谷丙转氨酶(ALT)、谷草转氨酶 (AST)和总胆红素(TB)水平均低于对照组,而血清蛋白(ALB)和血红蛋白(Hb)水平高于对照组,差异均有统计学意义(均P<0. 05);观察组并发症发生率为22.5%,明显低于对照组的37.5%,差异有统计学意义(P<0.05)。结论:SPVE法应用在肝癌合并门脉 高压手术中,可以显著减少术中的出血量和输血量,有利于术后肝功能的恢复,有效地降低术后并发症的发生。  相似文献   

4.
目的:探讨异丙酚对肝叶切除术患者肝功能与炎症因子水平的影响.方法:选择79例在我院接受肝叶切除的患者为研究对象并随机分为对照组和实验组,对照组予常规麻醉,实验组在对照组基础上加用异丙酚,比较两组患者肝功能与炎症因子的变化.结果:肝门阻断末,两组患者的血清ALT、AST、IL-1、IL-10、TNF-α水平均较肝门阻断前明显增加,实验组患者ALT、AST、IL-1及TNF-α水平均较对照组显著降低(P<0.05),IL-10水平较对照组显著升高(P<0.05).术后第4天,两组患者的血清ALT、AST、IL-1、1L-10、TNF-α水平比较均无显著差异(P>0.05),与肝门阻断前比较亦无显著差异(P>0.05).结论:异丙酚应用于肝叶切除术可有效减轻肝功能的损害,抑制促炎细胞因子的释放,促进抗炎细胞因子的生成,这可能是其保护肝功能的机制之一.  相似文献   

5.
为了确保黑鲷(Acanthopagrus schlegeli)和美国红鱼(Sciaenops ocellatus)在开放海域的养殖产量和鱼类养殖福利,在20℃下,对体长差异性不显著(P>0.05)的两种鱼进行续航游泳能力测试。首先,确定不同流速下的耐力游泳时间,然后选择耐力游泳时间为150min时的速度进行续航游泳实验。其中黑鲷和美国红鱼分别被迫以3.15和4.32 BL/s的恒定游泳速度,进行0、30min、60min、90min、120min和150min的测试,解剖鱼获得肌肉、血液和肝脏,测定样品在6个时间点的代谢物浓度,每个时间点保证3组有效数据。对0和150min的实验组对比,结果显示,两种鱼肝糖原、背肌乳酸和血糖浓度差异显著(P<0.05),肌肉糖原浓度差异不显著(P>0.05)。双变量相关分析显示,随着疲劳程度增加,肝糖原浓度下降,背肌乳酸和血糖上升。灰度关联分析和主成分分析显示,血糖和肝糖原浓度是影响疲劳的主要因素,但黑鲷相比美国红鱼,其浓度变化范围更大。综上:(1)美国红鱼比黑鲷拥有更强的游泳能力,而且黑鲷和美国红鱼不适合养殖在流速超过3.15和4....  相似文献   

6.
目的:探讨肝切除手术运用Pringle法阻断、半肝血流阻断(HVC)后对原发性肝癌合并肝硬化患者肝功能及肠黏膜屏障的影响。方法:选取2016年4月~2019年9月期间我院收治的原发性肝癌合并肝硬化患者93例,根据随机数字表法将患者分为A组(n=46,Pringle法阻断)和B组(n=47,HVC),比较两组患者围术期指标、肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)以及总胆红素(TBIL)]、肠黏膜屏障指标[D-乳酸,内毒素]及并发症发生情况。结果:两组阻断时间、术中失血量、手术时间比较无差异(P0.05);B组住院时间短于A组(P0.05)。两组术前、术后3 d、术后7 d ALT、AST、TBIL呈升高后降低趋势,且B组低于A组(P0.05)。两组患者术后并发症发生率比较无差异(P0.05)。两组术前、术后3 d、术后7dD-乳酸、内毒素呈升高后降低趋势,且B组低于A组(P0.05)。结论:与Pringle法阻断相比,原发性肝癌合并肝硬化患者在肝切除手术中运用HVC,可有效缩短住院时间,减轻肝功能及肠黏膜屏障损害,且不增加并发症发生率,临床应用价值较高。  相似文献   

7.
目的:研究经皮胃底曲张静脉栓塞术(PTVE)和经颈静脉肝内门体分流术(TIPS)治疗肝硬化门静脉高压合并食管胃底静脉曲张破裂出血的临床疗效,为临床治疗提供依据。方法:选取2001年4月到2015年4月我院肝硬化门静脉高压合并食管胃底静脉曲张破裂患者169例,根据手术方式分为PTVE组(行PTVE治疗)141例和TIPS组(行TIPS治疗)28例,比较两组术前、术后门静脉压力,术前、术后3个月、6个月以及1年两组Child-Pugh评分、白蛋白以及直接胆红素,并比较两组再出血和肝性脑病发生率。结果:TIPS组术后门静脉压力较术前显著降低,比较差异具有统计学意义(P0.05),术后PTVE组及TIPS组组间比较差异具有统计学意义(P0.05);两组术前和术后各时间直接胆红素无统计学意义(P0.05);PTVE组术后1年白蛋白水平显著升高,与术前和TIPS组比较差异具有统计学意义(P0.05),TIPS组术后白蛋白有所升高,但各时间比较差异无统计学意义(P0.05),PTVE组术后各时间Child-Pugh评分较术前明显改善,比较差异具有统计学意义(P0.05),TIPS组术后3个月和术后6个月Child-Pugh评分较术前明显改善,比较差异具有统计学意义(P0.05);两组术后再出血发生率比较无统计学意义(P0.05),PTVE组肝性脑病发生率显著低于TIPS组,比较差异具有统计学意义(P0.05)。结论:PTVE和TIPS治疗肝硬化门静脉高压合并食管胃底静脉曲张破裂出血效果相当,TIPS能显著降低门静脉压,PTVE能降低肝性脑病的发生率,改善患者Child-Pugh评分。  相似文献   

8.
目的:探讨异丙酚复合腰硬联合麻醉对腹腔镜手术患者氧代谢的影响。方法:选取2012年5月-2013年7月在我院进行妇科腹腔镜手术的患者153例,均采用异丙酚复合腰硬联合麻醉。观察并记录患者在麻醉前、麻醉后、气腹15 min、30 min、60 min及放气腹15 min的氧代谢。结果;与麻醉前比较,麻醉后及气腹过程中的氧供(DO2)较麻醉前下降,但无统计学意义(P0.05);而氧耗(VO2)、摄氧率(ERO2)均明显下降,差异具有统计学意义(P0.05);pH值、[HCO3-1]、动脉二氧化碳分压(PaCO2)、混合静脉二氧化碳分压(PvCO2)、动脉氧分压(PaO2)、混合静脉氧分压(PvO2)、动脉血氧浓度(SaO2)及混合静脉血氧浓度(SvO2)与均呈显著性差异,具有统计学意义(P0.05);放气腹后15 min各项参数与麻醉前比较,差异无统计学意义(P0.05)。结论:异丙酚复合腰硬联合麻醉效果良好,但对患者的氧代谢有一定影响,手术中应注意检测患者的呼吸循环功能。  相似文献   

9.
目的:对比分析开放根治性和后腹腔镜肾切除术的手术效果。方法:回顾对比分析2009年10月-2012年4月行开放根治性肾切除术28例和后腹腔镜肾切除术25例,观察手术时间、术中出血量,术后胃肠恢复时间,术后住院时间等情况。结果:开放根治性肾切除术手术时间为65-250 min平均155 min。后腹腔镜肾切除术手术时间70-240 min,平均152 min。两者不具有统计学差异(P〉0.05)。开放根治性肾切除术手术术中出血200~1000mL,平均600 mL。后腹腔镜肾切除术手术术中出血50-320 mL,平均165 mL。两者具有统计学差异(P〈0.05)。开放根治性肾切除术手术术后胃肠功能恢复时间48-98 h,平均74 h;术后住院时间7-12 d,平均10 d。后腹腔镜肾切除术手术术后胃肠功能恢复时间18-72 h,平均35 h;术后住院时间4-8 d,平均7 d。两者具有统计学差异(P〈0.05)。结论:后腹腔镜下手术肾切除具有创伤小、出血少、恢复快等优点,但对适应症选择方面应慎重。  相似文献   

10.
目的:利用~1H-MRS研究慢性肝病脑部代谢改变,并探讨~1H-MRS评估慢性肝病脑部代谢异常与肝硬化Child-Pugh分级的相关性。方法:选取经临床确诊为慢性肝炎肝硬化患者42例(child A 19例,child B14例,child C 9例)及健康志愿者15例(对照组),行磁共振平扫及磁共振单体素~1H-MRS检查,计算相关代谢物N-乙酰天门冬氨酸(NAA)、谷氨酰胺复合物(Glx)、胆碱(Cho)、肌醇(mI)和肌酸(Cr)的峰下面积及前四项指标与Cr的比值(NAA/Cr、Glx/Cr、Cho/Cr、mI/Cr),并进行统计学分析,同时对相关代谢物的变化与肝硬化Child-Pugh分级及肝硬化Child-Pugh分级与肝性脑病的关系进行相关性分析。结果:~1HMRS分析显示与正常对照组相比,慢性肝炎肝硬化组Glx/Cr值升高,Cho/Cr与mI/Cr值降低,且差异均有统计学意义(P0.05);不同程度肝硬化病例组对比显示,Glx/Cr值均随着肝硬化程度加重而增大,且Glx/Cr值的差异在child A、child B、child C组中均有统计学意义(P0.05);肝性脑病(HE)组与非肝性脑病组脑代谢物峰下面积比值Glx/Cr、Cho/Cr、mI/Cr比较,差异有统计学意义(P0.05);Child-Pugh分级与Glx/Cr呈正相关,与Cho/Cr、mI/Cr呈负相关;随着肝硬化程度加重,肝性脑病出现概率越高,差异有统计学意义(P0.05)。结论:~1H-MRS作为一种无创性的评价手段,能够反映慢性肝硬化及肝性脑病患者存在脑代谢物浓度异常改变,可作为早期诊断肝硬化、肝性脑病及评价肝硬化、肝性脑病严重程度的一项指标,在一定程度上评估肝性脑病与肝硬化分级具有相关性。  相似文献   

11.
巨大右半肝肿瘤切除过程中的出血量是决定手术能否成功的关键因素,控制手术过程中出血的技术也是右半肝切除术中的最重要的技术,有效控制术中出血的方法贯穿于整个手术过程中:良好的术前评估,术中于第一肝门处选择性阻断支配右半肝的入肝血流,于第二肝门处切断肝右静脉,于第三肝门处切断肝短静脉,在无血条件下用超声吸引刀切除预定的右半肝以及肝断面的处理等。此方法能有效控制手术过程中出血,保证左半肝血液供应,减轻肝脏缺血/再灌注损伤,减少术后肝功能不全的发生,保证了胃肠道血流的通畅,避免了黏膜屏障受损,全身血流动力学平稳,对其他脏器功能影响小,缩短了手术时间,极大地提高了手术的安全性。  相似文献   

12.
目的:探索一种新的、可靠的模型,用于惊恐条件反射的相关研究。方法:通过使用条件刺激(声音)和非条件刺激(足部电击)相结合的方法,可使动物对条件刺激产生惊恐反应。同时对动脉血压进行长期监测并测定利多卡因阻断杏仁基底外侧核群前后的血压变化。结果:该惊恐条件反射建立后(需经4d训练),单独给予动物条件刺激即可引起血压明显升高。我们将它作为条件反射已形成的标志。此时,用利多卡因阻断杏仁基底外侧核群的作用,单独给予动物条件刺激不再引起血压明显升高。结论:慢性动脉血压监测模型在惊恐条件反射的研究中是一种可靠的动物模型。  相似文献   

13.
20条正常麻醉犬经股动脉插管和枕骨下经皮穿刺在严格隔绝空气情况下,分别取得动脉血和脑脊液(CSF)样本,用IL-1303型血气分析仪和Beckman-700型生化分析仪检测酸碱变量及电解质。通过酶反应分光光度法检测乳酸(Lact)。应用(Na++K+)-(Cl-+Lact+HCO3-)公式计算阴离子隙(AG)。经统计学处理结果表明CSFPH、K+、AG<动脉血(p<0.01);CSFPCO2、HCO3-、Cl-、Lact>动脉血(p<0.01);CSFNa+同动脉血比较无明显差异(p>0.05)。  相似文献   

14.
目的:探讨不停跳心内直视手术对先天性心脏病(Congenital Heart Diseases,CHD)患者肺功能的保护作用。方法:将35例CHD患者按入院时的奇、偶数顺序随机分为停跳组(n=18)和不停跳组(n=17);患者均于CPB前及手术后1h查血气分析,监测呼吸指数(Respiratory Index,RI)及动脉血氧分压(Arterial Partial Pressure of Oxygen,PaO2)。结果:术后1h两组的RI均较术前升高,不停跳组的RI明显低于停跳组(P<0.05);术后1h不停跳组的PaO2明显高于停跳组(P<0.05)。结论:不停跳心内直视手术对CHD患者肺功能具有较好的保护作用。  相似文献   

15.
These experiments were performed to determine the factor(s) that regulate lactic acid production and utilization by rat tumors in vivo. Arteriovenous differences for glucose and lactic, pyruvic, 3-OH-butyric, and acetoacetic acids were measured across "tissue-isolated" Walker 256 sarcocarcinomas and Morris 5123C hepatomas in fasted rats anesthetized with sodium pentobarbital. Twenty-six per cent of the sarcocarcinomas (n = 53) and 48% of the hepatomas (n = 29) utilized blood lactic acid. The remainder released lactic acid into the venous blood. The steady-state rate of glucose consumption was similar in both lactate-producing and lactate-utilizing tumors. The range of lactate concentrations in the blood leaving the tumors was narrower than the range of lactate concentrations in the blood entering the tumors. This difference was caused by tumor lactic acid production at low arterial lactate concentrations and tumor lactic acid utilization at high arterial lactate concentrations. Individual tumors changed from lactic acid production to lactic acid utilization in a matter of minutes in response to an increase in the arterial lactic acid concentration. Mean lactic plus pyruvic acid concentrations and lactic/pyruvic acid ratios in the tumor venous blood were 2.15 +/- 0.22 and 23.4 +/- 3.7 mM, respectively, for Walker sarcocarcinoma 256 (n = 18) and 1.28 +/- 0.13 and 48.1 +/- 5.1 mM, respectively, for hepatoma 5123C (n = 11). The results suggest: that a steady-state lactic plus pyruvic acid concentration and lactic/pyruvic acid ratio are maintained in the tumor cell cytoplasm by the active glycolytic pathway and by lactic acid dehydrogenase; that the tumor intracellular concentrations equilibrate with the arterial blood and that the tumor steady state is expressed in the tumor venous blood; and that tumor lactic acid production or utilization results from the equilibration between the variable arterial lactic acid concentration and the more constant tumor intracellular steady-state lactic acid concentration. Since the arterial lactate concentration may be less than, greater than, or equal to the intracellular steady-state concentration, an individual tumor may produce, utilize or neither produce nor utilize lactic acid.  相似文献   

16.
Changes in hepatic ureagenesis following major hepatectomy are not well characterized. We studied the relation between urea synthesis and liver mass before and after major hepatectomy in humans. Fifteen patients scheduled for resection of malignancies in otherwise healthy livers were studied. Pre- and postoperative liver volume was assessed by computerized tomography-volumetry. During surgery, a primed, continuous infusion of [(13)C]urea was administered intravenously, and arterial blood samples were obtained hourly. Indocyanine green clearance was determined before and after resection. Seven patients underwent major hepatectomy, and eight patients underwent minor [<5% functional liver volume (total volume -- tumor volume)] or no resection, serving as controls. Resected functional liver volume in the major hepatectomy group averaged 60%. Urea synthesis per gram of functional liver tissue increased 2.6-fold following major hepatectomy, maintaining whole body urea synthesis. Arterial ammonia remained unchanged throughout the study, whereas following hepatectomy a hyperaminoacidemia occurred. In conclusion, immediately following major hepatectomy, urea synthesis per gram of functional liver tissue increases rapidly and proportionately to the amount of liver tissue resected, maintaining whole body urea synthesis at preoperative levels. This rapid and complete adaptation suggests that the capacity of urea synthesis is not limiting the maximum resectable volume in otherwise healthy livers.  相似文献   

17.
The development of diagnostic methods and new surgical techniques means it is increasingly important to have accurate knowledge of the anatomy of the hepatic arterial and biliary systems, including their variations, at extrahepatic and intrahepatic levels. The aim of this study was to determine how often the biliary and arterial systems run together and branch in the same pattern. Fifty corrosion casts of the liver were used to analyse the origin and branching patterns of arteries and the confluences of bile ducts. In addition, both systems were analysed to determine the frequency of normal arrangements and variations. The congruence of the course of both systems was analysed at the porta hepatis and in the left and right hemilivers down to the segmental level. A congruent course of the arterial and the biliary systems was identified in 38% of cases at the porta hepatis, in 32% of cases in the left hemiliver and in 30% of the right hemiliver. The congruence of both systems at the porta hepatis and in the left hemiliver was identified only if both systems were normal. In the right hemiliver, however, the congruence of both systems was identified even when both systems were variable, but only in 10% of cases. The results of the study show that, on the basis of knowledge of the course and branching of one system, the other system cannot be predicted.  相似文献   

18.

Background & Aims

Portal hyperperfusion after extended hepatectomy or small-for-size liver transplantation may induce organ dysfunction and failure. The underlying mechanisms, however, are still not completely understood. Herein, we analysed whether hepatectomy-associated portal hyperperfusion induces a hepatic arterial buffer response, i.e., an adaptive hepatic arterial constriction, which may cause hepatocellular hypoxia and organ dysfunction.

Methods

Sprague-Dawley rats underwent 30%, 70% and 90% hepatectomy. Baseline measurements before hepatectomy served as controls. Hepatic arterial and portal venous flows were analysed by ultrasonic flow measurement. Microvascular blood flow and mitochondrial redox state were determined by intravital fluorescence microscopy. Hepatic tissue pO2 was analysed by polarographic techniques. Hepatic function and integrity were studied by bromosulfophthalein bile excretion and liver histology.

Results

Portal blood flow was 2- to 4-fold increased after 70% and 90% hepatectomy. This, however, did not provoke a hepatic arterial buffer response. Nonetheless, portal hyperperfusion and constant hepatic arterial blood flow were associated with a reduced mitochondrial redox state and a decreased hepatic tissue pO2 after 70% and 90% hepatectomy. Microvascular blood flow increased significantly after hepatectomy and functional sinusoidal density was found only slightly reduced. Major hepatectomy further induced a 2- to 3-fold increase of bile flow. This was associated with a 2-fold increase of bromosulfophthalein excretion.

Conclusions

Portal hyperperfusion after extended hepatectomy does not induce a hepatic arterial buffer response but reduces mitochondrial redox state and hepatocellular oxygenation. This is not due to a deterioration of microvascular perfusion, but rather due to a relative hypermetabolism of the remnant liver after major resection.  相似文献   

19.
Plasma amino acid patterns in hepatocellular carcinoma   总被引:3,自引:0,他引:3  
Plasma amino acid levels were determined in 23 patients in comparison with 16 normal subjects and 17 patients with liver cirrhosis. Patients with hepatocellular carcinoma had elevated levels of the aromatic amino acids and lowered levels of the branched-chain amino acids, as seen in liver cirrhosis; however, they had lowered levels of alanine and glutamine as compared with normal subjects and with liver cirrhosis patients. Following treatment with intraarterial chemotherapy and/or transcatheter arterial embolization, plasma levels of alanine and glutamine recovered. These results suggest that the consumption of alanine and glutamine increase in hepatocellular carcinoma.  相似文献   

20.
目的:研究腹腔镜肝癌切除术对肝细胞癌中的治疗效果及对血清AFP、sEC、HGF、ICAM-1的影响。方法:选择2012年3月至2017年3月在我院接受治疗的肝细胞癌患者196例,根据治疗方案不同分为观察组和对照组,对照组给予开腹切除术治疗,观察组给予腹腔镜切除术治疗。观察并比较两组手术前后血清甲胎蛋白(AFP)、sEC、人类生长因子(HGF)、细胞间黏附分子-1(ICAM-1)及总胆红素(TBIL)、直接胆红素(DBIL)、谷丙转氨酶(ALT)及白蛋白(Alb)水平,术中出血量、术后绝对卧床时间、住院时间以及并发症发生率。结果:术后,观察组血清AFP、sEC、HGF、ICAM-1水平均明显低于对照组(P0.05);观察组TBIL、DBIL、ALT水平均显著低于对照组,Alb则显著高于对照组(P0.05);观察组术中出血量、绝对卧床时间以及住院时间均明显低于对照组(P0.05);且观察组术后并发症发生率明显低于对照组(P0.05)。结论:使用腹腔镜肝癌切除术治疗肝细胞癌,可降低患者血清AFP、sEC、HGF、ICAM-1水平从而提高其治疗效果,且术后并发症发生率较低。  相似文献   

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