摘要
目的探讨不解剖肝门的半肝入肝血流阻断(HIO)与全肝入肝血流阻断(TIO)在肝细胞癌患者行肝切除术中的临床应用效果。方法回顾性分析肝细胞癌行肝切除术患者63例,并随机分为两组,HIO组(33例)行不解剖肝门的半肝入肝血流阻断联合控制性低中心静脉压肝切除,TIO组(30例)行全肝入肝血流阻断联合控制性低中心静脉压肝切除。比较两组手术时间、血流阻断时间、术中出血量、术中输血情况,以及术后住院时间、ICU时间、术后第1、3天肝功能。结果两组手术时间、血流阻断时间、术后ICU时间、术中出血量、术中输血情况差异无统计学意义,HIO组术后住院时间显著短于TIO组[(14.1±5.5)d vs(17.2±5.8)d,t=-2.142,P=0.036];术后第1天HIO组患者血清白蛋白(Alb)水平显著高于TIO组[(34.2±3.5)g/L vs(31.6±3.8)g/L,t=2.784,P=0.007],其余肝功指标(ALT、AST、AKP、GGT、TB、DB)在术后第1天的水平差异无统计学意义,术后第3天两组间肝功指标水平差异无统计学意义。结论两种肝血流阻断技术同样安全、有效,半肝入肝血流阻断在术后住院时间及早期Alb水平恢复上更优。
Objective To compare the efficacy of half versus total vascular inflow occlusion without hilus dissection in hepatocellular carcinoma（HCC） patients undergoing hepatectomy. Methods Sixtythree HCC patients undergoing hepatectomy were divided into two groups： half vascular inflow occlusion group（HIO） and total vascular inflow occlusion group（TIO）. There were no hilus dissection and combined controlled low central venous pressure in both groups. Operation time, occlusion time, postoperative hospi-tal stay, postoperative ICU stay, blood loss and transfusion during operation and postoperative day 1 and day 3 liver functions were compared. Results Operation time, occlusion time, postoperative ICU stay,blood loss and transfusion during operation had no significant differences between two groups. Postopera-tive hospital stay was significantly shorter in HIO group [（14.1±5.5） d vs（17.2±5.8） d, t=-2.142, P=0.036].Postoperative day 1 serum albumin level was significantly higher in HIO group [（34.2 ±3.5） g/L vs（31.6±3.8） g/L, t=2.784, P=0.007], while levels of ALT, AST, AKP, GGT, TB, DB had no significant differences between two groups. Postoperative day 3 liver functions had no significant differences between two groups.Conclusion Both occlusion methods are safe and effective, while half vascular inflow occlusion leads to shorter postoperative hospital stay and higher serum albumin level the first day after operation.
出处
《中华普通外科学文献（电子版）》
2015年第4期23-27,共5页
Chinese Archives of General Surgery(Electronic Edition)
基金
福建省科技重点项目(2014Y0034)
关键词
肝细胞癌
肝切除术
半肝入肝血流阻断
全肝入肝血流阻断
Hepatocellular carcinoma
Hepatectomy
Half vascular inflow occlusion
Total vascu-lar inflow occlusion
