Application of hepatic vascular occlusion in surgery for hepatic cystic echinococcosis
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摘要:
目的 探讨不同肝血流阻断方法在肝囊性包虫病手术中的临床效果。 方法 回顾性分析近2年来手术中使用了入肝血流阻断的42例肝囊性包虫病患者的资料,依照入肝血流阻断方法分成2组:第一肝门阻断法(Pringle法)组24例和半肝血流阻断法组18例,比较其手术时间、血流阻断时间、出血量、术后5 d内血谷氨酸氨基转移酶、总胆红素峰值和术后并发症发生情况。 结果 半肝血流阻断组在术中出血量、术后肝功能方面优于Pringle法组(P<0.05),两组在手术时间、血流阻断时间及术后并发症方面的差异无统计学意义(P>0.05)。 结论 合适的入肝血流阻断方法在肝囊性包虫病手术中具有重要意义,具体采用Pringle法或半肝血流阻断法应根据患者病情、术中探查及医疗水平进行合理选择。 Abstract:Objective To investigate the clinical efficacy of two different hepatic vascular occlusion techniques in surgery for hepatic cystic echinococcosis. Methods 42 patients with hepatic cystic echinococcosis undergoing surgical intervention in recent 2 years were included in a retrospective analysis. 24 cases received surgeries with Pringle maneuver (Pringle group) and the other 18 cases underwent surgeries with hemi-hepatic vascular occlusion (non-Pringle group). The operation time, vascular occlusion time, intraoperative blood loss, postoperative liver function and postoperative complications were recorded and compared between two groups. Results Compared with Pringle group, non-Pringle group manifested significantly less intraoperative blood loss and better postoperative liver function (P<0.05). No significant differences were found in the operation time, blood inflow occlusion time or postoperative complications between the two groups (P>0.05). Conclusion Appropriate hepatic vascular occlusion has significant value in surgical treatment of hepatic cystic echinococcosis, and the choice of the optimal vascular occlusion method should be made based on the patient's condition, intraoperative findings and the condition of the local medical facilities. -
Key words:
- cystic echinococcosis /
- liver /
- surgical treatment /
- vascular occlusion
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表 1 Pringle阻断法与半肝血流阻断法指标比较(Mean±SD)
方法 手术时间
(min)阻断时间
(min)术中出血
(mL)术后5 d内血ALT峰值
(μmmol/L)术后5 d内血TB峰值
(μmmol/L)术后并发症(n) 有 否 Pringle阻断法(24例) 159±38 26±6 410±154 143±65 31±13 4 20 半肝血流阻断法(18例) 151±36 24±7 313±127 99±41 22±8 3 15 t/χ2 0.69 1.00 2.17 2.52 2.59 0.18 P 0.49 0.33 0.04 0.02 0.01 0.68 ALT: 血谷氨酸氨基转移酶; TB: 总胆红素. -
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