摘要
目的比较曲式单一腹主动脉阻断无血切肝术（简称曲式无血切肝术）和Pringle阻断切肝术在118例肝脏肿瘤切除中的应用效果。方法回顾性分析59例行曲式无血切肝术（QG组）和同期59例行Pringle阻断切肝术（PG组）肝肿瘤患者的临床资料，比较两组患者术中血压、出血量、手术麻醉时间、血管阻断时间以及术后肝功能的变化等。结果QG组患者在术中采取血压调控措施之后，生命体征平稳，血压波动幅度不大，且能被安全调控。QG组患者术中平均切肝出血量为（96．254-18．45）ml，显著低于PG组患者[（536．25±35．65）ml，P〈0．05]。QG组患者的手术时间和麻醉时间分别为（227．58±28．20）min和（249．48±31．35）mln，均比PG组患者[（261．46±32．12）min和（286．58±5．62）min]显著缩短（均P〈0．05）。QG组患者术后肝功能损害也较PG组轻（P〈0．05）。结论曲式无血切肝术能基本实现临床无血切肝的目的，其术后肝功能恢复优于Pringle阻断切肝术；曲式无血切肝术搛作安全、简便易行，可在血源紧张的医院及有一定操作技能的肝外科医师中开展。
Objective To compare the results of application of Qu single abdominal aorta clamping for bloodless hepatectomy and Pringle hepatectomy in 118 cases of liver tumors.Methods The clinical data of 118 patients,including 59 patients undergoing Qu single abdominal aorta clamping for bloodless hepatectomy (Group QG ) and 59 patients undergone Pringlr first hepatic portal clamping hepatectomy (Group PG) since March 2009 in the Ningbo Tumor Hospital and Jiangxi Provincial Hospital were retrospectively reviewed.The changes of blood pressure,oxygen saturation,urine volume,intravenous fluid volume,amount of bleeding,time of abdominal aorta (or first hepatic portal) clamping,duration of operation and anesthesia,and other intraoperative indexes of the two groups were compared,and the changes of peritoneal drainage,blood tests,liver functions,etc.before operation and 1,3,7,14 days after the hepatectomy in the two groups were also analyzed. Results After taking appropriate measures for intraoperative blood pressure control,only small fluctuations of blood pressure,which could be safely adjusted and controlled with stable vital signs,was observed in the group QG.The amount of intraoperative bleeding in the group QG was (96.25 ± 18.45 ) ml,significantly less than (536.25 ± 35.65 ) ml in the group PG ( P ＜ 0.05).In the group QG,both the duration of operation time [ (227.58 ± 28.20) min] and duration of anesthesia [ (249.48 ±31.35 ) min] were significantly shorter than that [ (261.46 ± 32.12) min and (286.58 ± 35.62)min,respectively ] in the group PG (both P ＜ 0.05 ).The postoperative liver dysfunction in the group QG was also milder than that in the group PG ( P ＜ 0.05).Conclusions For liver rumor patients,Qu single abdominal aorta clamping for bloodless hepatectomy can basically achieve the goal of bloodless hepatectomy.This surgical operation is simple and safe,worthy of recommendation to skillful liver surgeons in hospitals there are some difficulties of blood supply.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2012年第6期477-480,共4页
Chinese Journal of Oncology
基金
基金项目：江西省科技支撑计划项目（2009BSB11001）
