中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2008年
12期
907-910
,共4页
吴健雄%钟宇新%荣维淇%崔修铮%王黎明%白晓枫%李智宇%吴凡%刘立国
吳健雄%鐘宇新%榮維淇%崔脩錚%王黎明%白曉楓%李智宇%吳凡%劉立國
오건웅%종우신%영유기%최수쟁%왕려명%백효풍%리지우%오범%류입국
肝肿瘤%肝切除术%肝区域性进出血流阻断%超声乳化吸引刀
肝腫瘤%肝切除術%肝區域性進齣血流阻斷%超聲乳化吸引刀
간종류%간절제술%간구역성진출혈류조단%초성유화흡인도
Liver neoplasms%Hepatectomy%Hepatic vascular exclusion%Caritationalultrasonic surgical aspiration
目的 探讨选择性血流阻断配合超声乳化吸引刀切除中央型肝肿瘤的效果.方法 选择性阻断肿瘤所在肝叶的进出血流,超声乳化吸引刀解剖,行中央区肝段切除.结果 自2006年7月至2008年1月,采用这种外科技术治疗中央型肝肿瘤46例.本组患者术前肝功能Child A级43例,Child B级3例.39例患者一次性肝区域性全血流阻断8～33 min.术中出血量100～2400ml,平均490ml.43例术后在一周内肝功能恢复至A级;3例术后出现腹水,其中1例并发黄疸;2例发生胆瘘;1例胃瘫,1例术后第3天并发大面积心梗死亡.35例恶性肿瘤患者中位随访9个月,1例患者术后10个月因肿瘤腹腔及肝内转移死亡,34例患者至今无瘤生存.结论 肝区域性进出血流阻断能有效控制切肝时的出血;应用超声乳化吸引刀切肝,解剖清晰,综合应用这两种技术,能较安全地切除肝脏任何部位的肿瘤.
目的 探討選擇性血流阻斷配閤超聲乳化吸引刀切除中央型肝腫瘤的效果.方法 選擇性阻斷腫瘤所在肝葉的進齣血流,超聲乳化吸引刀解剖,行中央區肝段切除.結果 自2006年7月至2008年1月,採用這種外科技術治療中央型肝腫瘤46例.本組患者術前肝功能Child A級43例,Child B級3例.39例患者一次性肝區域性全血流阻斷8～33 min.術中齣血量100～2400ml,平均490ml.43例術後在一週內肝功能恢複至A級;3例術後齣現腹水,其中1例併髮黃疸;2例髮生膽瘺;1例胃癱,1例術後第3天併髮大麵積心梗死亡.35例噁性腫瘤患者中位隨訪9箇月,1例患者術後10箇月因腫瘤腹腔及肝內轉移死亡,34例患者至今無瘤生存.結論 肝區域性進齣血流阻斷能有效控製切肝時的齣血;應用超聲乳化吸引刀切肝,解剖清晰,綜閤應用這兩種技術,能較安全地切除肝髒任何部位的腫瘤.
목적 탐토선택성혈류조단배합초성유화흡인도절제중앙형간종류적효과.방법 선택성조단종류소재간협적진출혈류,초성유화흡인도해부,행중앙구간단절제.결과 자2006년7월지2008년1월,채용저충외과기술치료중앙형간종류46례.본조환자술전간공능Child A급43례,Child B급3례.39례환자일차성간구역성전혈류조단8～33 min.술중출혈량100～2400ml,평균490ml.43례술후재일주내간공능회복지A급;3례술후출현복수,기중1례병발황달;2례발생담루;1례위탄,1례술후제3천병발대면적심경사망.35례악성종류환자중위수방9개월,1례환자술후10개월인종류복강급간내전이사망,34례환자지금무류생존.결론 간구역성진출혈류조단능유효공제절간시적출혈;응용초성유화흡인도절간,해부청석,종합응용저량충기술,능교안전지절제간장임하부위적종류.
Objective To improve the resection rate of central type hepatoma. Method Under selective exclusion of hepatic blood flow and the use of caritational ultrasonic surgical aspiration (CUSA), hepatectomy of central hepatic segments was performed for liver tumors. Result There were 46 cases in this group. Preoperative hepatic function was Child A in 43 cases and Child B in 3 cases. Regional entire bloodstream was excluded ranging from 8 to 33 minutes in 39 cases, Intraoperative blood loss was 100 to 2400 ml,the average was 490 ml. Postoperative hepatic function recovery to Child A grade in 43 cases within one week, postoperative aacites developed in 3 cases, jaundice in 1 case, biliary fistula in 1 case, gastroplegia in 1 case. One patient died of myocardial infarction 3 days postoperatively. Thirty-five malignant cases were followed-up with a mean period of 9 months, one died of intraabdominal metastasis 10 months postoperatively, the other 34 cases was alive without recurrence. Conclusion Hepatic regional entire bloodstream exclusion is effective in the control of intraoperative blood loss ; Hypersound-emulsifying- attractor separates blood vessels and bile ducts in hepatic hilar region. The combination of these two techniques helps in the resection of central hepatic tumors.
