CAJ | 학술논문

目的：探讨选择性肝门阻断联合逆行肝切除治疗巨大肝癌对健侧肝组织功能的保护作用。方法将2012年3月~2014年2月四川省内江市第二人民医院收治的61例巨大肝癌患者随机分为对照组和观察组，对照组30例患者采用传统肝切除术治疗，观察组31例患者采用选择性肝门阻断联合逆行肝切除治疗，比较两组患者术后健侧肝组织中丙二醛含量、钙离子浓度、超氧化物歧化酶含量、凋亡指数及术后7d血清前白蛋白、谷丙转氨酶、总胆红素含量。结果观察组患者术后丙二醛、钙离子浓度及凋亡指数均显著低于对照组，超氧化物歧化酶含量显著高于对照组，差异均有统计学意义(均P<0.05)；观察组患者术后7 d肝功能指标前白蛋白水平显著高于对照组，谷丙转氨酶水平显著低于对照组，差异有统计学意义(P<0.05)；两组患者术后7 d总胆红素水平比较，差异无统计学意义(P>0.05)。结论选择性肝门阻断联合逆行肝切除治疗巨大肝癌能够有效降低患者健侧肝组织缺血再灌注损伤，保护健侧肝脏肝功能。
목적：탐토선택성간문조단연합역행간절제치료거대간암대건측간조직공능적보호작용。방법장2012년3월~2014년2월사천성내강시제이인민의원수치적61례거대간암환자수궤분위대조조화관찰조，대조조30례환자채용전통간절제술치료，관찰조31례환자채용선택성간문조단연합역행간절제치료，비교량조환자술후건측간조직중병이철함량、개리자농도、초양화물기화매함량、조망지수급술후7d혈청전백단백、곡병전안매、총담홍소함량。결과관찰조환자술후병이철、개리자농도급조망지수균현저저우대조조，초양화물기화매함량현저고우대조조，차이균유통계학의의(균P<0.05)；관찰조환자술후7 d간공능지표전백단백수평현저고우대조조，곡병전안매수평현저저우대조조，차이유통계학의의(P<0.05)；량조환자술후7 d총담홍소수평비교，차이무통계학의의(P>0.05)。결론선택성간문조단연합역행간절제치료거대간암능구유효강저환자건측간조직결혈재관주손상，보호건측간장간공능。
Objective To discuss the protective effect of selective hepatic portal occlusion combined with retrograde hepatic resection for uninjured side liver function of huge liver cancer. Methods 61 patients with huge liver cancer in the Second People's Hospital of Neijiang City in Sichuan Province from March 2012 to February 2014 were randomly divided into control group (30 cases) with traditional surgery for liver resection and observation group (31 cases) with selective hepatic portal occlusion therapy combined with retrograde liver resection. The levels of MDA content, calcium ion concentration, superoxide dismutase (SOD) content, apoptosis index in the uninjured side of liver tissue, and serum prealbumin (PA), glutamic pyruvic transaminase and total bilirubin 7 d after operation of both groups were compared. Results The levels of MDA content, calcium ion concentration and apoptosis index of observation group after operation were significant lower than those of the control group (P< 0.05); the level of SOD content of observation group after operation was significant higher than that of the control group (P<0.05). 7 d after operation the level of PA of the ob-servation group was significant higher than that of the control group (P<0.05);the level of glutamic pyruvic transami-nase of the observation group was significant lower than that of the control group (P< 0.05); there was no significant difference in total bilirubin level between the two groups (P > 0.05). Conclusion Selective hepatic portal occlusion combined with retrograde hepatic resection for huge liver cancer can effectively reduce the ischemia-reperfusion injury of uninjured side hepatic tissue, and protect the liver function.