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目的 逆行肝切除是治疗难切性肝癌的有效方法 ,本文报道了 2 44例临床经验。方法 常规肝切除方法切除困难的 2 44例巨大、显露困难或下腔静脉受累的肝癌采用逆行切肝法结合血管外科技术予以切除 (A组 ) ,同期临床特征类似的 31例肝癌采用常规切肝法切除 ,作为对照 (B组 )。结果 两组均无手术死亡 ,A组与B组相比 ,术中出血量较少 ( 12 90± 998ml比 2 2 86± 136 3ml)、术后胸水发生率 ( 2 6 /2 44比 10 /31)、腹水发生率 ( 72 /2 44比 19/31)、中度到重度黄疸率 ( 14 /2 44比 5 /31)、手术区积液率 ( 17/2 44比 7/31)、膈下感染率 ( 3/2 44比 1/31)、胆漏发生率 ( 2 /2 44比 1/31)、切口感染率 ( 3/2 44比 1/31)以及ALT恢复时间 ( 13.8± 5 .1天比 18.9± 8.9天 )均较低 ,差别具有统计学意义 (P <0 .0 1)。结论 对于难切性肝癌而言 ,逆行肝切除是安全有效的手术方法。
Purpose Retrograde hepatectomy is an effective method for the treatment of difficult-to-treat liver cancer. In this paper, 244 cases of clinical experience were reported. Methods Retrograde hepatectomy combined with vascular surgery was performed in 444 patients with huge, difficult-to-reveal or inferior vena cava involvement of hepatectomy. Conventional hepatectomy France excision, as a control (B group). Results There was no operative death in both groups. The blood loss in group A was less than that in group B (12 90 ± 998 ml vs 2286 ± 136 3 ml), and the incidence of pleural effusion was 26 6 44 2 10 / 31), the incidence of ascites (72/244 to 19/31), moderate to severe jaundice (14/244 to 5/31), the rate of effusion (17/2 44 to 7/31) The rates of subphrenic infection (3/2 44 vs 1/31), bile leakage (2/44 vs 1/31), incisional infection (3/2 44 vs 1/31) and ALT recovery time (13.8 ± 5. 1 days than 18.9 ± 8.9 days) were lower, the difference was statistically significant (P <0.01). Conclusions For difficult-to-treat liver cancer, retrograde hepatectomy is a safe and effective surgical method.