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目的 讨论无血切肝在复杂型 HCC中的价值。对象和方法 收集自 1997.1- 1999.1收治的复杂型 HCC2 2例 ,统计其性别、年龄及肿瘤大小、肿瘤的侵犯程度、围手术期处理方法、术中出血和输血量、阻断时间、术后肝衰、手术死亡、术后复发和生存时间等指标。结果 肿瘤最常侵犯的大血管是门脉 ,达 45 .45 % ;平均术中出血量为 818.18± 491.5 7ml,输血量为 890 .91± 6 15 .5 6 ml,术中无血阻断的时间为 2 2 .0 0± 13.0 8(6～ 5 5 )分钟 ,手术死亡率为 9.0 9% ,1年复发率为 45 .45 % ,1年生存率为 77.2 7%。结论 改良式无血切肝法能提高复杂型 HCC的手术切除率 ,减少术中出血量和输血量 ,延长肝脏热缺血耐受时间 ,手术死亡率低 ,能有效延长晚期 HCC的生存时间 ,因而它是一种安全有效的手术方法
Objective To discuss the value of liver transplantation in complex HCC. Subjects and Methods Two cases of complicated type HCC2 were collected from 1997.1 to 1999.1. Their gender, age and tumor size, degree of tumor invasion, perioperative management, intraoperative bleeding and blood transfusion, time of occlusion, postoperative liver Failure, surgery, postoperative recurrence and survival time and other indicators. Results The most common tumor invaded by the tumor was portal vein, reaching 45.45%. The mean intraoperative blood loss was 818.18 ± 491.5 7ml and the blood transfusion volume was 890.91 ± 6.155.6 ml. The time was 22.0 ± 13.0 8 (6-55) minutes, the operative mortality was 9.0 9%, the one-year recurrence rate was 45.45% and the one-year survival rate was 77.2 7%. Conclusions Modified transhepatic non-hepatectomy can improve the surgical resection rate, reduce intraoperative blood loss and blood transfusion, prolong the duration of hepatic ischemic tolerance, reduce the mortality rate, prolong the survival time of advanced HCC effectively, So it is a safe and effective surgical method