半肝阻断联合肝静脉阻断在复杂肝癌精准肝切除中的应用

目的:探讨半肝血流阻断联合肝静脉阻断技术在精准肝切除中的应用价值。方法:回顾性分析我科2013年1月至2014年12月共120例行半肝血流阻断联合肝静脉阻断的精准肝切除病例,作为治疗组。另选单用第一肝门阻断的复杂肝癌半肝切除患者318例为对照。结果:治疗组在控制术中出血和输血量方面优于单用半肝血流阻断的对照组,治疗组术中平均出血量为650±46 m L,平均输血量为410±76 m L,差别有统计学意义(P0.05);治疗组在平均手术时间和平均住院时间方面均少于对照组,但两组差别无统计学意义(P0.05)。结论:半肝血流阻断联合肝静脉阻断技术在复杂肝癌的精准肝切除术中合理使用能有效的减少术中出血,提高了手术安全,降低了术中输血量,最大限度保留剩余肝细胞体积,减少了缺血再灌注的损失。

Application of Half Liver Vascular Occlusion Combined with Hepatic VeinsOcclusion in Complex Precise Liver Resection of Hepatocellular Carcinoma

Objective:To discuss the application value of hemihepatic blood flow occlusion combined with hepatic vein occlusiontechnology in precise hepatectomy.Methods:A total of 120 cases of hemihepatic resection treated with hemihepatic blood flow occlusion(treatment group) were retrospectively analyzed in our department from January 2013 to December 2014. Another318 patients singletreated with the first hepatic portal occlusion complicated liver cancer hepatectomy were selected as control.Results:The intraoperativeblood loss in treatment group was for an average of 650± 46 mL, and the average amount of blood transfusion was 410 ± 76 mL, andthe amount of intraoperative bleeding and blood transfusion was better than that in control group, and the difference was statisticallysignificant (P < 0.05). The average operation time and hospitalization stay were less than that in control group, but no statisticallysignificant difference between the two groups (P > 0.05).Conclusion:Half liver blood flow blocking hepatic vein blocking technology inprecision liver resection of hepatocellular carcinoma complicated reasonable use can effectively reduce intraoperative bleeding andimprove the operation safety, reduce the amount of intraoperative blood transfusion, retain maximum residual liver cell volume, reducethe loss of ischemia reperfusion.