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目的探讨经腹经心包全肝血流阻断方法在肝切除术中的地位。方法2003年1月至2007年12月,安徽医科大学第一附属医院肝胆外科将38例肝切除术按血流阻断方法分为两组,传统全肝血流阻断组(THVE组)22例,经腹经心包全肝血流阻断组(经心包组)16例,分析应用不同血流阻断方法对术后肝功能及并发症发生的影响。结果两组病人均成功切除肿瘤,两组手术时间、阻断时间及术后并发症发生率差异均无统计学意义(P>0.05)。两组术后第3天和第7天血清丙氨酸转氨酶(ALT)之间差异有统计学意义(P<0.05),术后第7天血清天冬氨酸转氨酶(AST)之间差异有统计学意义(P<0.05),经心包组术后近期肝功能恢复快。结论经腹经心包全肝血流阻断肝切除术可提高肿瘤切除率,改善病人预后。
Objective To investigate the status of transhepatic perineal total hepatic artery occlusion in hepatectomy. Methods From January 2003 to December 2007, 38 cases of liver resection were divided into two groups according to the method of blocking blood flow. The traditional total hepatic vascular block group (THVE group) 22 Cases, the transabdominal peritoneal whole liver blood flow block group (pericardium group) 16 cases, analysis of different methods of blocking blood flow on postoperative liver function and complications. Results The tumors were successfully resected in both groups. There was no significant difference in operative time, occlusion time and incidence of postoperative complications between the two groups (P> 0.05). Serum alanine aminotransferase (ALT) was significantly different between the two groups on the third day and the seventh day after operation (P <0.05). The difference of serum aspartate aminotransferase (AST) on the seventh day after surgery was Statistical significance (P <0.05), pericardial group after the recent rapid recovery of liver function. Conclusion Transhepatic percutaneous transhepatic arterial blood flow blocking hepatectomy can improve tumor resection rate and improve prognosis.