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目的 比较肝癌肝切除时阻断与不阻断入肝血流的优缺点。方法 2 49例病人包含两组 :甲组 112例 ,肝切除时阻断入肝血流 ,乙组 137例 ,肝切除时不阻断入肝血流。比较两组病人术中失血量 ,术后谷丙转氨酶恢复时间 ,并发症发生率 ,1、2、3、年复发率和存活率。结果 甲乙两组估计术中失血量分别为 846 .4± 984.7ml和 5 93 .9± 6 45 .6ml(P <0 .0 1)。术后并发症发生率分别为 47.3 %和 19% (P <0 .0 1) ,1、2、3年复发率为甲组 2 1.4%、38.4%、42 .9% ,乙组 11.7%、2 6 .3 %、32 .8% ,1、2、3年存活率为甲组 92 .8%、79.4%、6 9.6 % ,乙组 97.1%、90 .0 %、79.5 % ,(P <0 .0 1)。结论 肝癌肝切除时不阻断入肝血流优于阻断入肝血流。
Objective To compare the advantages and disadvantages of blocking and not blocking blood flow to the liver during hepatectomy for liver cancer. Methods 2 Forty-nine patients consisted of two groups: 112 patients in group A, liver blood flow blocked during liver resection, and 137 patients in group B. Hepatic blood flow was not blocked during liver resection. The intraoperative blood loss was compared between the two groups, postoperative alanine aminotransferase recovery time, complication rate, 1, 2, 3, annual recurrence rate and survival rate. Results The estimated intraoperative blood loss in the two groups was 846.4 ± 984.7 ml and 59.39 ± 65.6 ml, respectively (P < 0.01). The incidence of postoperative complications was 47.3% and 19%, respectively (P < 0.01). The relapse rate in the 1st, 2nd and 3rd years was 21.4%, 38.4%, 42.9% in group A, and 11.7% in group B. The survival rate of 26.3%, 32.8%, 1, 2, and 3 years was 92.8%, 79.4%, and 69.6% in group A, and 97.1%, 90.0%, and 79.5% in group B, respectively (P < 0 .0 1). Conclusion It is better to block the hepatic blood flow than to block the hepatic blood flow during liver resection.