CAJ | 학술논문

目的比较三种不同入肝血流阻断肝切除方式的安全性及其对肝脏的损伤程度.方法回顾性分析90例肝癌肝切除病例资料.接受全肝入肝血流阻断、半肝入肝血流阻断和保留半肝动脉阻断者各30例,比较其手术时间、出血量、术后肝功能恢复情况.结果三种方式手术时间、出血量无差异,但半肝阻断组术中发生2例门静脉分支损伤,1例发生大出血.后两种方式术后1 d谷丙转氨酶和总胆红素上升较少、术后7 d恢复较快.结论保留半肝动脉入肝血流阻断的肝切除是一种安全、简便的方法,适合于肿瘤位于半肝内(除尾状叶肿瘤),与第一、二、三肝门关系不密切,特别是合并严重肝硬化的病人.
목적 비교삼충불동입간혈류조단간절제방식적안전성급기대간장적손상정도.방법 회고성분석90례간암간절제병례자료.접수전간입간혈류조단、반간입간혈류조단화보류반간동맥조단자각30례,비교기수술시간、출혈량、술후간공능회복정황.결과 삼충방식수술시간、출혈량무차이,단반간조단조술중발생2례문정맥분지손상,1례발생대출혈.후량충방식술후1 d곡병전안매화총담홍소상승교소、술후7 d회복교쾌.결론 보류반간동맥입간혈류조단적간절제시일충안전、간편적방법,괄합우종류위우반간내(제미상협종류),여제일、이、삼간문관계불밀절,특별시합병엄중간경화적병인.
Objective To compare the safety and damage to liver function of 3 methods of hepatic infusive vascular occlusion in hepatectomy for hepatocellular carcinoma. Methods Retrospectively, the clinical data of patients undergoing curative liver resection with pan- (n=30) and hemi(n= 30) vascular occlusion or hemi-hepatic artery reservation (n= 30) method were analyzed. Results All patients in the 3 groups had similar surgical duration and blood loss. Two and one patients from group 2 suffered from portal vein impairment and hemorrhea, respectively. Patients from group 1 had higher serum alanine aminotransferase and total bilirubin on days 1 and 7 after surgery. Conclusion Hepatectomy with hemi-hepatic artery reservation, which was not closely related to hepatic hilum, is safe and convenient for the resection of tumor involving hemi-liver and is especially suitable for the patients with severe liver cirrhosis.