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[目的]研究原发性肝细胞肝癌血液引流区域(外科切缘)的类型及与手术的相关性。[方法]2004~2007年67例肝癌患者通过术前腹部肝动脉造影螺旋CT检查确定肝癌血液引流区域,并据此作为外科切缘切除肿瘤。[结果]外科切缘可以分为3种类型:边缘型、门脉型和低血流型。边缘型(引流至肿瘤周围)最多见(50例),主要施行范围小的局部切除;门脉型(引流至门脉分支)次之(12例),需行范围大的解剖性肝切除;其余5例为低血流型,主要施行局部肝切除。[结论]外科切缘因肿瘤血流动力学变化而异,外科切缘的类型是确定手术切除范围的依据。
[Objective] To study the type of blood drainage area (surgical margin) and its correlation with surgery in primary hepatocellular carcinoma. [Methods] From 2004 to 2007, 67 patients with hepatocellular carcinoma (HCC) were examined by preoperative abdominal hepatic artery angiography to determine the blood drainage area of the liver cancer, and as a surgical margin for resection of the tumor. [Results] Surgical margin can be divided into three types: marginal, portal and low blood flow type. (50 cases) were found in the marginal type (drainage to the tumor), and the main application scope was small partial excision. The portal vein type (drainage to the portal vein branch) was the second (12 cases), requiring extensive range of anatomic liver resection. The remaining 5 cases of low blood flow type, the main implementation of partial hepatectomy. [Conclusion] The margin of surgical margin varies with the hemodynamic changes of the tumor. The type of surgical margin is the basis for determining the scope of surgical resection.