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目的:探讨半肝血流阻断联合肝静脉阻断技术在精准肝切除中的应用价值。方法:回顾性分析我科2013年1月至2014年12月共120例行半肝血流阻断联合肝静脉阻断的精准肝切除病例,作为治疗组。另选单用第一肝门阻断的复杂肝癌半肝切除患者318例为对照。结果:治疗组在控制术中出血和输血量方面优于单用半肝血流阻断的对照组,治疗组术中平均出血量为650±46 m L,平均输血量为410±76 m L,差别有统计学意义(P<0.05);治疗组在平均手术时间和平均住院时间方面均少于对照组,但两组差别无统计学意义(P>0.05)。结论:半肝血流阻断联合肝静脉阻断技术在复杂肝癌的精准肝切除术中合理使用能有效的减少术中出血,提高了手术安全,降低了术中输血量,最大限度保留剩余肝细胞体积,减少了缺血再灌注的损失。
Objective: To investigate the value of semi-hepatic blood flow occlusion combined with hepatic venous occlusion in precision hepatectomy. Methods: Retrospective analysis of our department from January 2013 to December 2014 a total of 120 cases of semi-hepatic blood flow blocking hepatic venous occlusion combined with hepatic resection cases, as the treatment group. Another selection of the first hepatic portal vein occlusion in patients with semi-hepatectomy of liver cancer in 318 cases as a control. Results: The treatment group was better than the control group in the treatment of hemorrhage and blood transfusion only in the control group. The average blood loss in the treatment group was 650 ± 46 m L and the average blood transfusion volume was 410 ± 76 m L , The difference was statistically significant (P <0.05); the treatment group in the average operation time and the average hospital stay were less than the control group, but the difference between the two groups was not statistically significant (P> 0.05). Conclusion: Hepatic blood flow occlusion combined with hepatic vein occlusion technique can effectively reduce the intraoperative blood loss, improve the safety of operation, reduce the intraoperative blood transfusion and maximize the remaining liver Cell volume, reducing the loss of ischemia-reperfusion.