Matsumata T, Kanematsu T, Okudaira Y, Sugimachi K, Zaitsu A, Hirabayashi M
Surgery. 1987 Sep;102(3):493-7.
To determine factors leading to pleural effusion after hepatectomy, the frequency of pleural effusion was investigated in 68 patients who underwent hepatic resection, with or without dissection of the right coronary ligament. In 36 of 44 patients (81.8%) who underwent hepatic resection with complete dissection of the right coronary ligament, and in two of 24 (8.3%) who underwent the procedure without dissection of this ligament, pleural effusion developed in the right hemithorax (p less than 0.001). Difference in pressure between the abdominal and thoracic cavities was considered to lead to ascites in the chest via the diaphragmatic triangular area (where there is no parietal peritoneum). While investigating the preventive effect of mechanical ventilation following hepatic resection on the occurrence of pleural effusion in 12 patients, we concluded that effusion could be prevented with use of mechanical ventilation--an approach that retained the intrathoracic pressure in a positive state.
为了确定肝切除术后导致胸腔积液的因素，我们对68例行肝切除术的患者进行了研究，这些患者术中是否离断右冠状韧带。在44例行肝切除术并完全离断右冠状韧带的患者中，有36例（81.8%）出现右侧胸腔积液；而在24例未离断该韧带的患者中，有2例（8.3%）出现右侧胸腔积液（P<0.001）。腹腔与胸腔之间的压力差被认为可通过膈三角区（此处无壁腹膜）导致胸腔积液。在对12例患者进行肝切除术后机械通气对胸腔积液发生的预防作用研究时，我们得出结论：通过机械通气维持胸腔内正压可预防积液。
