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目的探讨肝癌肝切除时肝血流阻断法的合理选用。方法采用半肝血流阻断、缺血预处理、间歇性全肝血流阻断3种方法行肝切除术。对3组术前、术后肝功能变化及术中出血进行比较。结果83例患者无手术死亡。术后两周肝功能恢复正常或接近术前水平,3组分别为95.8%(23/24)、74.1%(20/27)和56.3%(18/32),组间比较差异有统计学意义(P<0.05或P<0.01);术中出血量分别为(188±31.70)ml、(196±45.54)ml和(389±74.10)ml,前两组与后一组差异有统计学意义(P<0.01)。结论肝癌肝切除时选择性半肝血流阻断是减少术中出血和术后肝功能恢复较快的有效肝血流阻断方法之一。
Objective To investigate the rational selection of hepatic blood flow occlusion during hepatectomy of liver cancer. Methods Hepatectomy was performed with three methods of hemihepatic blood flow occlusion, ischemic preconditioning and intermittent whole liver blood flow occlusion. Three groups of preoperative and postoperative liver function changes and intraoperative bleeding were compared. Results 83 patients died without surgery. Two weeks after operation, the liver function returned to normal or close to the preoperative level, with 95.8% (23/24), 74.1% (20/27) and 56.3% (18/32) respectively in the 3 groups, with statistically significant differences (188 ± 31.70) ml, (196 ± 45.54) ml and (389 ± 74.10) ml, respectively. The difference between the first two groups and the latter group was statistically significant (P <0.05 or P <0.01) P <0.01). Conclusion Selective half hepatic blood flow occlusion during hepatectomy for liver cancer is one of the effective ways to reduce hepatic bleeding and postoperative recovery of hepatic function.