唐学虎

【摘要】 目的：分析渐进式肝门阻断法在肝切除手术中的应用效果。方法：于笔者所在医院2018年10月-2019年10月收治的肝切除手术患者中选取80例，所有患者均采用肝门阻断法治疗，根据肝门阻断方式分为正常阻断组（n=40）和渐进阻断组（n=40），比较两组手术效果及并发症情况。结果：两组手术时间、术中出血量及肝门阻断时间比较，差异均无统计学意义（P>0.05）;渐进阻断组术后48 h腹腔引流量少于正常阻断组，术后1 d的ALT、TBIL水平低于正常阻断组，血红蛋白水平高于正常阻斷组，差异均有统计学意义（P<0.05）;两组并发症发生率比较，差异无统计学意义（P>0.05）。结论：渐进式肝门阻断法应用于肝切除手术对患者肝功能造成的损伤更小，更有助于恢复患者肝脏功能，且并发症不多，安全性高。

【关键词】 肝门阻断法 肝切除手术 并发症 渐进式阻断 应用效果

doi：10.14033/j.cnki.cfmr.2020.19.052 文献标识码 B 文章编号 1674-6805（2020）19-0-03

Study on the Application of Progressive Hepatic Portal Occlusion in Hepatectomy/TANG Xuehu. //Chinese and Foreign Medical Research， 2020， 18（19）： -130

[Abstract] Objective： To analyze the application effect of progressive hepatectomy. Method： From October 2018 to October 2019， 80 patients with hepatectomy in our hospital were selected. All patients were treated with hepatectomy. According to the way of hepatectomy， they were divided into normal occlusion group （n=40） and progressive occlusion group （n=40）. The operation effect and complications of the two groups were compared. Result： There were no significant differences between the two groups in operation time， intraoperative blood loss and hepatic portal block time （P>0.05）. After 48 hours of operation， the level of intraperitoneal drainage was less in the progressive occlusion group than that in the normal occlusion group， the ALT， TBIL levels after 1 day of operation were lower， and the hemoglobin was higher， the differences were statistically significant （P<0.05）. There was no significant difference in the incidence of complications between the two groups （P>0.05）. Conclusion： The application of progressive hepatectomy in hepatectomy can cause less damage to the liver function of patients， and it is more helpful to restore the liver function of patients， with low complications and high safety.

[Key words] Hepatic portal occlusion Hepatectomy Complications Progressive occlusion Application effect

First-authors address： The First Hospital of Danjiangkou， Danjiangkou 442700， China

肝切除手术是临床治疗各类肝脏疾病的重要方法，利用Pringle手法进行肝门阻断能够有效减少患者术中出血量，减轻患者手术创伤，因而在肝切除手术中得到广泛应用[1]。以往Pringle手法阻断肝门主要采用持续性阻断，阻断20 min，根据手术需要可在开放血流后再次阻断15～20 min[2]。本研究采用渐进式肝门阻断法，其具体应用效果分析如下。

1 资料与方法

1.1 一般资料

纳入病例80例，均为2018年10月-2019年10月在笔者所在医院接受肝切除手术的患者。纳入标准：（1）均符合肝切除手术指征;（2）CT等影像学检查显示能够完整切除肝脏病灶。排除标准：（1）严重器质性疾病;（2）凝血功能障碍;（3）肝肾功能障碍者。根据肝门阻断方法分为正常阻断组和渐进阻断组，各40例。正常……