摘要
目的探讨原发性肝癌切除术后胸水发生的成因。方法选取手术切除的原发性肝癌病人133例为对象进行回顾性研究。结果133例病人中有69例出现胸水。胸水组(G1组)中行右肝手术尤其是行右三角韧带及右冠状韧带分离者比例明显高于无胸水组(G2组),且术后并发腹水量较高。无胸水组术后肝功能明显好于胸水组。术前肝功能、术中出血量、肝门阻断时间、肿瘤大小等两组间比较差异无统计学意义。结论肝切除术后并发胸水,主要和手术部位、术后肝功能及肝周韧带分离有关。肝切除对右肝韧带的游离和膈肌损伤是导致术后胸水发生的主要原因。在围手术期维持良好肝功能的前提下,术中仔细分离肝周韧带,减少膈肌的损伤,可能有助于减少术后胸水的发生。
Objective To investigate the causes of pleural effusion after hepatectomy. Methods 133 cases of primary hepatic carcinoma （PHC） underwent hepatectomy were enrolled in this retrospective study. Results Pleural effusion emerged in 69 cases after hepatectomy. The ratio of cases underwent fight hepatectomy especially with dissection of triangnlare ligamentum and coroary ligament in plenral effusion group （ group G1 ） was significantly higher than that in no-pleural effusion group （ group G2）. The volume of effusion after operation in group G1 was larger than that in group G2. The postoperative hepatic function was much better in group G2 than that in group G1. There was no statistically significant different between the two groups concerning the factors such as preoperative hepatic function, volume of bleeding, obstructive time of portal vein and size of tumor. Conclusions Complicated pleural effusion after hepatectomy is mainly related to operative site, postoperative hepatic function and dissection of peri-hepatie ligaments. The main causes of pleural effusion are the dissection of fight hepatic ligaments and damage of diaphragm during operation. Maintenance of fine hepatic function before and after operation, careful dissection of pefi-hepatic ligaments and avoiding damage on diaphragm may help to reduce the incidence of postoperative pleural effusion.
出处
《中国癌症防治杂志》
CAS
2009年第2期134-136,共3页
CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT
关键词
原发性肝癌
胸水
Primary hepatic carcinoma（PHC）
Pleural effusion
