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采用常温下经腹全肝血流阻断技术对5例用一般方法难以安全切除的伴有肝硬变的原发性肝癌病人成功地进行了肝切除。阻断肝门蒂和肝上、下方下腔静脉以阻断全肝血流,阻断时间为4～16min,平均9.6min。切除肝右叶3例、肝左叶1例、肝中叶1例。手术均采用双侧肋缘下屋顶状切口。手术全过程定时监测平均动脉压、脉率、中心静脉压、心电图和尿量,术后2周还定期检测血清转氨酶、乳酸脱氢酶、碱性磷酸酶、血胆红素、凝血酶原时间和肌酐等。结果表明,血液动力学和生化改变不明显,病人耐受良好,术后无并发症出现,均康复出院。
Using transabdominal total hepatic artery occlusion at room temperature, hepatectomy was successfully performed on 5 cases of hepatocellular carcinoma patients with liver cirrhosis who were difficult to remove safely using general methods. The hepatic portal pedicle was blocked and the superior and inferior vena cava were blocked to block the hepatic blood flow. The blocking time was 4 to 16 minutes, with an average of 9.6 minutes. The right hepatic lobe was removed in 3 cases, the left hepatic lobe in 1 case, and the middle hepatic lobe in 1 case. All the operations were performed with bilateral subcostal roof-like incisions. Mean arterial pressure, pulse rate, central venous pressure, electrocardiogram, and urine volume were regularly monitored during the entire procedure. Serum transaminase, lactate dehydrogenase, alkaline phosphatase, blood bilirubin, and prothrombin time were also regularly monitored 2 weeks after surgery. And creatinine and so on. The results showed that the hemodynamic and biochemical changes were not obvious, the patient was well tolerated, no complications occurred after surgery, and all were discharged.