摘要
目的探讨在原发性肝癌解剖性切肝中运用绕肝提拉法(liver hanging maneuver,LHM)的优越性。方法收集重庆医科大学附一院肝胆外科2006年9月至2007年12月没有采用LHM的解剖性切肝28例原发性肝癌患者(非LHM组)与2008年1月(即我们开始采用LHM)起至2010年9月运用LHM的解剖性切肝20例原发性肝癌患者(LHM组)的资料作比较,比较两组之间的术前一般情况,手术时间,断肝时间,术中出血量,术中输血量,住院时间和并发症率。结果术前一般情况在两组之间没有显著差异。而术中失血量,输血量,LHM组较非LHM组有减少[(800±600)ml vs(1200±500)ml,P<0.05];虽然手术时间在两组之间没区别,但断肝时间LHM组比对照组有显著缩短[(25±15)分钟vs(40±25)分钟,P<0.05];住院时间LHM组较非LHM组缩短[(18±7)日vs(25±15)日,均P<0.05]。而术后肝功能衰减发生率,并发症率和死亡率两组之间没有区别。结论绕肝提拉法可以缩短原发性肝癌解剖性切肝的断肝时间及住院时间,减少术中失血量。在原发性肝癌解剖性切肝中运用肝脏提拉法有明显的优势。
Objective To explore the superiority of liver hanging maneuver （LHM） in application of anatomic hepatectomy of primary liver cancer. Methods The clinical data of 20 patients undergoing anatomic hepatectomy by liver hanging maneuver from January 2008 to September 2010 in Department of Hepatobiliary Surgery of the First Affiliated Hospital of Chongqing Medical University were compared with those of 28 patients without liver hanging maneuver from September 2006 to December 2007. The two groups were compared in preoperative data, amounts of intraoperative bleeding and blood transfusion, time of liver transection, duration of hospitalization and postoperative complications. Results No operative death was found in this study, and the amounts of time of liver transection, intraoperative bleeding, transfusion and duration of hospitalization decreased significantly in the liver hanging maneuver group [（800 ± 600） ml vs （1 200 ± 500） ml; （25 ± 15） min vs （40 ± 25） min; （18 ± 7） day vs （25 ± 15） day, all P 0.05]. There was no significant difference in the liver function test, postoperative complications, liver function recovering, patient demographics, preoperative liver function tests and operating time between the two groups. Conclusion Liver hanging maneuver is feasible due to its superiority of reduced time of liver transection, less amount of intraoperative blood loss, and shorter duration of hospitalization in anatomic hepatectomy of primary liver cancer.
出处
《临床医学工程》
2011年第12期1867-1869,共3页
Clinical Medicine & Engineering
关键词
绕肝提拉法
解剖性切肝
原发性肝癌
Liver hanging maneuver
Anatomic hepatectomy
Primary liver cancer
