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目的探讨陈氏双悬吊法在中肝叶肿瘤切除术中的作用。方法应用陈氏双悬吊法联合区域性入肝血流阻断行中肝叶肿瘤切除26例,术中置入陈氏双悬吊带、肝下下腔静脉阻断带、第一肝门及不同区域入肝血流阻断带。根据切除边界分配阻断带使用,尽量减少阻断带使用数量、阻断时间和残肝缺血时间,最大限度保留功能性残肝体积。结果全组肿瘤最大直径均数为(9.2±2.6)cm。陈氏双悬吊带仅用于肿瘤右侧切开11例,一次性同时使用陈氏双悬吊带和右肝入肝血流阻断带阻断时间为(13.5±3.8)分钟,联合用于肿瘤左右侧切开15例,阻断时间(18.2±6.4)分钟。出血量(425±227)ml,手术时间(153±47)分钟。丙氨酸氨基转移酶、天门冬氨酸氨基转移酶均于术后10天内恢复正常或接近术前值。结论陈氏双悬吊法使中肝叶肿瘤切除出血和肝损伤可控、恢复快。
Objective To investigate the effect of Chen’s double-suspension method in the resection of middle hepatic lobe tumor. Methods Twenty-six cases of hepatic lobe tumor resection were treated by Chen’s double-suspension combined with regional hepatic vein occlusion. The patients were placed in Chen’s double-dangling suture, inferior hepatic vena cava occlusion zone, Different regions of the liver blood flow blocking zone. According to the excision border allocation blocking zone use, minimize the use of blocking zone, blocking time and residual liver ischemia time, to maximize the retention of functional residual liver volume. Results The mean diameter of tumor in the whole group was (9.2 ± 2.6) cm. Chen double sling only for the right side of the tumor incision in 11 cases, a one-time use of Chen double sling and right hepatic and hepatic blood flow blockade blocking time (13.5 ± 3.8) minutes, combined for cancer Left and right side incision in 15 cases, blocking time (18.2 ± 6.4) minutes. Bleeding volume (425 ± 227) ml, operation time (153 ± 47) minutes. Alanine aminotransferase, aspartate aminotransferase within 10 days after surgery were returned to normal or near preoperative values. Conclusion Chen double suspension method in the removal of the middle lobe tumor hemorrhage and liver injury controllable, fast recovery.