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目的:探究选择性入肝血流阻断(SPVE法)在肝癌合并门脉高压手术中的临床应用效果。方法:选择我院2009年10月~2014年10月期间确诊为肝癌合并门脉高压的患者80例,按照随机数字数表法分为观察组和对照组各40例,观察组行SPVE法进行血流阻断,对照组行全入肝血流阻断法(Pringle法)进行血流阻断。对比两组手术时间、阻断血流时间、手术中出血量、输血量、手术前后患者肝功能相关指标及术后并发症发生率。结果:两组手术时间和血流阻断时间对比差异无统计学意义(P>0.05),而观察组术中出血量及输血量均小于对照组,差异具有统计学意义(P<0.05);术后观察组血液中谷丙转氨酶(ALT)、谷草转氨酶(AST)和总胆红素(TB)水平均低于对照组,而血清蛋白(ALB)和血红蛋白(Hb)水平高于对照组,差异均有统计学意义(均P<0.05);观察组并发症发生率为22.5%,明显低于对照组的37.5%,差异有统计学意义(P<0.05)。结论:SPVE法应用在肝癌合并门脉高压手术中,可以显著减少术中的出血量和输血量,有利于术后肝功能的恢复,有效地降低术后并发症的发生。
Objective: To investigate the clinical effect of selective hepatic blood flow occlusion (SPVE) in hepatocellular carcinoma with portal hypertension. Methods: Eighty patients diagnosed with HCC with portal hypertension from October 2009 to October 2014 in our hospital were divided into observation group (40 cases) and control group (40 cases) according to random number table. The observation group was performed with SPVE method Blood flow was blocked, and the control group was blocked by Pringle method. The operation time, blood flow time, intraoperative blood loss, blood transfusion volume, indexes of liver function before and after operation and postoperative complications were compared between the two groups. Results: There was no significant difference between the two groups in the time of operation and the time of blocking blood flow (P> 0.05). However, the amount of blood loss and blood transfusion in the observation group were all less than those in the control group (P <0.05). The levels of ALT, AST and TB in the postoperative observation group were lower than those in the control group, while the levels of ALB and Hb in the observation group were higher than those in the control group (P <0.05). The incidence of complications in the observation group was 22.5%, which was significantly lower than that in the control group (37.5%), the difference was statistically significant (P <0.05). Conclusion: The application of SPVE in hepatocellular carcinoma with portal hypertension can significantly reduce intraoperative blood loss and blood transfusion, which is conducive to the recovery of postoperative liver function and effectively reduce the incidence of postoperative complications.