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目的:探讨选择性半肝血流阻断在肝海绵状血管瘤切除中的应用效果。方法:回顾性分析2006年1月—2011年1月经手术切除的104例肝海绵状血管瘤患者的临床资料。其中26例行选择性半肝血流阻断(A组),78例行第一肝门阻断(Pringle法)(B组)。比较并分析两种方法对术中情况、术后肝功能恢复、并发症发生率等指标的影响。结果:104例手术均顺利完成。两组间术中失血量、输血量、阻断时间、血氧饱和度以及术后肠道恢复时间、并发症等指标的差异均无统计学意义(均P>0.05),但B组术中外周动脉血压及术中脉搏变化明显大于A组(均P<0.01)。术后肝功能指标如ALT,AST,ALB,TBIL等改变,B组优于A组,差异均有统计学意义(P<0.05或P<0.01)。结论:肝海绵状血管瘤切除术中采用选择性半肝血流阻断,能有效地减轻肝血流阻断对全身血流动力学的影响,减轻缺血再灌注损伤,有利于术后肝功能恢复。
Objective: To explore the application effect of selective hemivertebra blockade in hepatic cavernous hemangioma resection. Methods: The clinical data of 104 patients with hepatic cavernous hemangioma surgically excised from January 2006 to January 2011 were retrospectively analyzed. Seventy-six patients underwent selective hemihepatic occlusion (group A) and 78 patients underwent first hepatic obstruction (group B). The effects of two methods on intraoperative status, postoperative recovery of liver function and incidence of complications were compared and analyzed. Results: 104 cases were successfully completed. Blood loss, blood transfusion volume, time to block, blood oxygen saturation and postoperative intestinal recovery time, complications and other indicators were not significantly different between the two groups (all P> 0.05), but in group B Week arterial blood pressure and intraoperative pulse changes were significantly greater than the A group (all P <0.01). Postoperative liver function indexes such as ALT, AST, ALB, TBIL and other changes, B group was better than A group, the difference was statistically significant (P <0.05 or P <0.01). Conclusion: Selective hemihepatic partial occlusion of hepatic cavernous hemangioma resection can effectively reduce the effect of hepatic blood flow block on systemic hemodynamics, relieve ischemia-reperfusion injury and facilitate postoperative liver Function recovery.