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为减少手术中出血,阻断第一肝门行肝切除手术已在临床上广泛应用。但是,第一肝门阻断时间过长容易造成合并肝硬化病人手术后肝功能衰竭。因此,对肝门阻断的方法已有不少改进。近来,我院对部分病人行肝切除术时采用单侧入肝血流选择性阻断,报告如下。 1 临床资料一般资料:从1993年9月至1995年9月,我科共采用入肝血流阻断行肝切除术(不包括规则性切除和全肝血流阻断)切除原发性肝癌(HCC)76例。其中采用Pringles法56例(肝门组),切除右肝肿瘤36例,左肝20例,本组中位年龄40岁,肿瘤平均直径9.27±4.89cm;单侧入肝血流选择性阻断20例(单侧组),右侧入肝血流阻断18例,左侧入肝血流阻断2例,本组病人中位年龄50岁,肿瘤平均直径10.31±4.42cm。
In order to reduce intraoperative bleeding, blocking the first hepatic portal hepatectomy has been widely used in clinical practice. However, if the first hepatic portal occlusion is too long, hepatic failure after surgery can be caused in patients with cirrhosis. Therefore, there have been many improvements in methods of hepatic occlusion. Recently, in our hospital, selective hepatic blood flow to the unilateral hepatic vein was used for partial hepatectomy. The report is as follows. 1 Clinical data General information: From September 1993 to September 1995, our department applied total hepatectomy with hepatic blood flow blocking (excluding regular resection and total hepatic blood flow block) to remove primary liver cancer. (HCC) 76 cases. Among them, 56 patients were treated with Pringles method (Himons group). 36 patients with right liver tumors and 20 patients with left liver were removed. The median age of this group was 40 years old and the mean diameter of the tumor was 9.27±4.89 cm. Selective blockage of unilateral hepatic blood flow was performed. In 20 patients (unilateral group), 18 cases of right hepatic blood flow blockade and 2 cases of left hepatic hepatic artery occlusion were treated. The median age of the patients in this group was 50 years and the average diameter of the tumor was 10.31±4.42 cm.