摘要
目的探讨选择性/超选择性阻断出入肝血管后解剖性肝切除对肝脏疾病患者手术中失血量、术后肝功能、并发症、住院时间等相关因素的影响。方法选择/超选择出入肝血管阻断后解剖性肝切除66例,其中肝段切除22例、右半肝切除12例,左半肝切除6例,Ⅱ+Ⅲ段肝切除19例,Ⅵ+Ⅶ段肝切除5例,Ⅴ+Ⅷ段肝切除2例。观察其对术中失血量、输血量、术后肝功能、术后并发症、术后住院时间等的影响。结果本组切除术中出血量(437±123)m l,所有病例手术中均未输血;术后患者肝功能损伤程度较轻,54例术后1周恢复至术前水平;无肝功能衰竭等相关并发症;术后平均住院时间13.1 d,无围手术期死亡。结论对于适应症明确的肝脏疾病,通过选择性或超选择性出入肝血流阻断后行肝脏解剖性切除可有效减少术中出血、降低术后相关并发症的发生。
Objective To evaluate the influence of anatomical hepatectomy with selective/uhra-selective afferent and efferent vascular occlusion on intra-operative blood loss, blood transfusion, post-operative complications and hospitalization. Methods With selective or ultra-selective vascular occlusion,22 segmentectomies, 12 right half hepatectomies,6 left. half hepatectomies, 19 Ⅱ ＋ Ⅲ segmentectomies, Ⅵ ＋ Ⅶ segmeutectomies, and 2 Ⅴ ＋ Ⅷ segmentectomies were performed. Intra-operative blood loss, blood transfusion, postoperative liver function, complications and postoperative hospitalization were evaluated. Results Mean intra-operative blood loss was （437 ± 123） ml, no blood transfusion was required, post-operative liver function recovered to pre -operative level within 1 week in 54 cases, no post-operative liver failure or peri-operative death was observed,mean post-operative hospitalization was （13. 1 ± 3.4）d. Conclusions To indicated hepatectomy cases,anatomical hepatectomy with selective or ultra-selective vascular occlusion can be performed,which decreases intra-operative blood loss, preserves residual liver function, and decreases post-operative complications.
出处
《肝胆外科杂志》
2007年第6期410-412,共3页
Journal of Hepatobiliary Surgery
关键词
肝切除
血管阻断
并发症
Hepatectomy
operation
vascular occlusion
