| 摘要: |
| ［摘要］ 目的 观察低中心静脉压联合间歇性入肝血流阻断在肝切除术中的应用效果。方法 选择该院2011-01～2013-03因肝细胞肝癌行肝切除术的病例60例，随机分为低中心静脉压联合间歇性入肝血流阻断组（研究组）和选择性半肝血流阻断组（对照组），每组30例。比较两组术前一般情况、平均手术时间、术中出血量及术中术后输血量等手术情况，以及手术后肝、肾功能的变化情况。结果 两组患者术前一般情况、肝门阻断时间、术中出血量、肝截断面面积、切肝重量及术中术后输血量等比较，差异均无统计学意义(P均>0.05)。研究组的平均手术时间为(207.15±49.27)min，短于对照组的(254.03±58.70)min，差异有统计学意义(P<0.01)。两组患者的尿素氮(BUN)和肌酐(Cr)的各时点和组间比较差异均无统计学意义(P>0.05)。两组的总胆红素（TBIL）和丙氨酸转氨酶(ALT)在各时点间比较差异有统计学意义(P<0.05)，TBIL组间比较差异无统计学意义(P>0.05),术后第1天、第3天研究组的ALT高于对照组，差异有统计学意义(P<0.05)，两组间术后第7天的ALT比较差异无统计学意义(P>0.05)。两组间术后并发症的发生率比较差异无统计学意义(P>0.05)。结论 低中心静脉压联合间歇性入肝血流阻断是一种简便易行和安全有效的方法，可有效地减少肝切除术中的出血量和减轻术后残肝缺血性损害。 |
| 关键词: 低中心静脉压 肝血流阻断 肝切除术 |
| DOI：10.3969/j.issn.1674-3806.2016.08.09 |
| 分类号:R 657.3 |
| 基金项目: |
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| The application of intermittent total hepatic inflow occlusion with low central venous pressure in hepatectomy |
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LONG Di, LI Bi-wan, BI Yong-hao, et al.
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The application of intermittent total hepatic inflow occlusion with low central venous pressure in hepatectomy
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| Abstract: |
| ［Abstract］ Objective To investigate the efficacy and safety of intermittent total hepatic inflow occlusion with low central venous pressure in hepatectomy.Methods Sixty patients with hepatocellular carcinoma who underwent hepatectomy from January 2011 to March 2013 were randomly divided into the research group(treated with the intermittent total hepatic inflow occlusion with low central venous pressure) and the control group(treated with selective hemihepatic blood flow occlusion), with 30 cases in each group. The general conditions before the operation, the average operation time, total bleeding volume, blood transfusion, postoperative hepatic and renal function changes were compared between the two groups.Results There were no significant differences between the two groups in the general conditions before the operation, time of vascular clamping, total bleeding volume, area of liver transection plan, weight of resected liver tissues and the amount of blood transfusion（P>0.05）. The average operation time of the research group［(207.15±49.27)min］ was significantly shorter than that of the control group［(254.03±58.70)min］（P<0.01）. The levels of TBIL and ALT in the research group were significantly higher on the first and the third day after the operation than those in the control group(P<0.05). There were no significant differences in the incidences of the complication between the two groups（P>0.05）.Conclusion Intermittent total hepatic inflow occlusion with low central venous pressure is a simple, safe and effective method for hepatectomy, which can reduce bleeding and lessen hepatic ischemia-reperfusion injury. |
| Key words: Low central venous pressure Hepatic vascular occlusion Hepatectomy |
