Nagao T, Inoue S, Mizuta T, Saito H, Kawano N, Morioka Y
Ann Surg. 1985 Jul;202(1):42-9. doi: 10.1097/00000658-198507000-00006.
The indications and operative results of hepatic resections were investigated in 100 consecutive patients over the past 20 years. There were 61 hepatocellular carcinoma, 13 hepatolithiasis, and 26 other miscellaneous diseases. An overall hospital mortality rate was 25%. It was 26, 0, and 35% in patients with hepatocellular carcinoma, hepatolithiasis, and other diseases, respectively. There was not any significant difference between survived and deceased cases in their preoperative laboratory data. The volume of operative blood loss in deceased cases was significantly larger than that in survived cases, so the influence of operative blood loss on morbidity and mortality was investigated. The incidences of postoperative bleeding, hepatic insufficiency, pulmonary insufficiency, and hospital death were significantly higher in patients whose operative blood loss exceeded 5000 ml. These results indicate that operative blood loss is one of the critical factors that decide the operative prognosis.
在过去20年中，对连续100例患者的肝切除指征和手术结果进行了研究。其中有61例肝细胞癌、13例肝内胆管结石和26例其他杂症。总体医院死亡率为25%。肝细胞癌、肝内胆管结石和其他疾病患者的死亡率分别为26%、0和35%。存活病例和死亡病例术前实验室数据无显著差异。死亡病例的术中失血量明显多于存活病例，因此对术中失血量对发病率和死亡率的影响进行了研究。术中失血量超过5000 ml的患者术后出血、肝功能不全、肺功能不全和医院死亡的发生率明显更高。这些结果表明，术中失血量是决定手术预后的关键因素之一。
