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肝脏切除术中半肝血管阻断的安全性

Safety of hemihepatic vascular occlusion during resection of the liver.

作者信息

Makuuchi M, Mori T, Gunvén P, Yamazaki S, Hasegawa H

出版信息

Surg Gynecol Obstet. 1987 Feb;164(2):155-8.

PMID:3810429
Abstract

To minimize both intraoperative bleeding and circulatory and biochemical disturbances due to the interruption of blood flow to the liver, we developed a technique for selective, mostly unilobar, control of the hilar vessels to the liver called hemihepatic vascular occlusion. One hundred and fifty-three patients who underwent hepatic resection were divided into four groups with and without cirrhosis of the liver and with and without hemihepatic vascular occlusion which was limited to 30 minutes followed by five minutes of perfusion, which was repeated if necessary. This technique reduced the intraoperative blood loss and the postoperative hyperbilirubinemia significantly but did not produce larger postoperative change of transaminases or lactic dehydrogenase serum levels when compared with similar resections without vascular control.

摘要

为了尽量减少术中出血以及因肝脏血流阻断导致的循环和生化紊乱,我们开发了一种选择性控制肝脏肝门血管的技术,主要是单叶控制,称为半肝血管阻断。153例行肝切除术的患者被分为四组,分别为有或无肝硬化、有或无半肝血管阻断,半肝血管阻断时间限制在30分钟,随后灌注5分钟,必要时重复此操作。与未进行血管控制的类似切除术相比,该技术显著减少了术中失血量和术后高胆红素血症,但并未使术后转氨酶或乳酸脱氢酶血清水平出现更大变化。

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