CAJ | 학술논문

目的探讨一种新的入肝动脉血流选择性阻断技术,以减少手术失血量、降低手术风险.方法选择肝右叶肝癌患者56例,其中实验组25例,对照组31例.2组患者均采取常规后入路法行肝肿瘤切除.实验组先选择性阻断右肝动脉血流,再游离肿瘤所在肝右叶,当游离完成后再结合门静脉阻断,行肝肿瘤切除.对照组不先行阻断肝动脉血流,其他手术步骤与实验组相同.结果实验组与对照组的年龄、性别、肿瘤直径、肝硬化、HBsAg、AFP、门静脉主干癌栓、肝门阻断时间、手术时间、切除范围均无明显差别.实验组较对照组术中出血量明显减少,( 272±113)ml比(547±221)ml,两组比较差异有统计学意义(t=-5.6,P＜0.01).实验组患者术后恢复顺利,住院时间较对照组缩短,差异有统计学意义(t=-2.12,P＜0.05).结论选择性阻断右肝叶的入肝动脉血流技术安全、可靠,能有效减少手术失血量,降低手术风险,提高安全性.
목적 탐토일충신적입간동맥혈류선택성조단기술,이감소수술실혈량、강저수술풍험.방법 선택간우협간암환자56례,기중실험조25례,대조조31례.2조환자균채취상규후입로법행간종류절제.실험조선선택성조단우간동맥혈류,재유리종류소재간우협,당유리완성후재결합문정맥조단,행간종류절제.대조조불선행조단간동맥혈류,기타수술보취여실험조상동.결과 실험조여대조조적년령、성별、종류직경、간경화、HBsAg、AFP、문정맥주간암전、간문조단시간、수술시간、절제범위균무명현차별.실험조교대조조술중출혈량명현감소,( 272±113)ml비(547±221)ml,량조비교차이유통계학의의(t=-5.6,P＜0.01).실험조환자술후회복순리,주원시간교대조조축단,차이유통계학의의(t=-2.12,P＜0.05).결론 선택성조단우간협적입간동맥혈류기술안전、가고,능유효감소수술실혈량,강저수술풍험,제고안전성.
Objective To evaluate selectave blocking of hepatic artery tor hepatectomy in onder to reduce blood loss. Methods Patients with liver cancer in right hepatic lobe were randomly divided into study group (n =25 ) and control group (n =31).Conventional posterior approach for liver tumor resection was applied.In study group,right hepatic artery was first freed and inflow was temporarily blocked before the right liver lobe was freed from its peripheral attachment.Then hepatectomy was performed under Pringle's manouver. Result in term of blood loss was compared with that in control group in which hepatectomy was performed under Pringle's. Results There were no significant differences between two groups in age,sex,tumor size,liver cirrhosis,HBsAg,AFP and tumor emboli in portal vein.Blood loss in study group was significantty less (272 ± 113 ) ml than that in control group (547 ± 221) ml,the difference was statistically significant(t =-5.6,P ＜ 0.01).The length of hospital stay was significantly shorter than that in control group ( t =- 2.12,P ＜ 0.05 ). Conclusions Initial hepatic artery blochade before liver freeing during the process of hepatectomy significantly reduced intraoperative in blood loss liver cancer patients.