摘要
作者对7例半肝以上肝切除术及2例ⅦⅧ肝段切除应用止血带在腹腔内围绕肝下肾上及膈下肝上之下腔静脉,同时用橡皮管控制肝门血管,而暂不阻断,以预防术中可能发生的肝静脉或/和下腔静脉损伤大出血,其中2例还同时控制膈下腹腔动脉以上的腹主动脉。9例中7例无意外,2例术中发生肝中静脉损伤大出血,经止血带迅速控制,修补裂口,抢救成功。本文对肝叶切除术中误伤肝静脉或/和下腔静脉的原因和预防处理方法进行了讨论,认为在病变接近或累及第二肝门或下腔静脉的肝叶肝段切除,以及在半肝或三叶切除术中常规控制下腔静脉和肝门是一个简而有效的防治肝静脉或/和下腔静脉损伤大出血的好方法。
Nine cases of hemihepatectomy or extensive liver resection and two cases of en blocresection of hepatic segments 7 and 8 were performed by means of prior control of the inferior vena cava by passing cotton slings around the infrahepatic suprarenal vena cava and the vena cava above the liver just below the diaphragm Also the hepatic artery and portal vein were secured by a piece of rubber tube. In two cases the abdominal aorta between the diaphragm and the coeliac trunk was controled by a piece of sling. No accident was present in seven cases, but massive bleeding from injured middle hepatic vein occured in twe. The hemorrhage was controlled successfully by prompt obstruction of the vena cava, and then the laceration of the vein was repaired. The reasons, the prevention. and the management of injury of hepatic vein and vena cava were discussed. It was thought that prior cortrol of the inferior vena cava was an effective measure to secure and treat hepatic vein and vena cava injury during hemihepatectomy, extensive liver resection, or resection of the liver disease which involed the second hepatic hilus or vena cava.
出处
《华西医学》
CAS
北大核心
1991年第4期475-477,共3页
West China Medical Journal
关键词
肝
切除术
手术
肝静脉
损伤
Prior control of the inferior vena cava
Liver resection
Massive bleeding caused by injury of the hepatic vein and inferior vena cava
