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目的:探讨3种不同肝血流阻断方法在腹腔镜肝左外叶切除术中的临床效果。方法:回顾性分析2008—2015年间因原发性肝细胞癌行腹腔镜肝左外叶切除术的45例患者临床资料,患者术中肝血流控制分别采用Pringle法(全肝阻断组,18例)、半肝血流阻断法(半肝阻断组,17例)、七步断肝法分步阻断(七步断肝组,10例)。比较3组相关临床指标的差异。结果:3组术中失血量差异无统计学意义(P>0.05),但七步断肝组在手术时间、术后肝功能恢复、胃肠功能恢复、并发症发生率、住院时间等指标上明显优于全肝阻断组与半肝阻断组(均P<0.05)。结论:利用七步断肝法行腹腔镜肝左外叶切除术安全、简便、可行,且对术者腹腔镜技术要求不高,适合各级医院借鉴和开展。
Objective: To investigate the clinical effect of three different methods of hepatic blood flow occlusion in laparoscopic hepatic lobectomy. Methods: A retrospective analysis of clinical data of 45 patients with laparoscopic surgery for left hepatic lobectomy for primary hepatocellular carcinoma from 2008 to 2015 was performed. The patients underwent Pringle method (total hepatic occlusion group, 18 cases), half hepatic blood flow blocking method (half hepatic occlusion group, 17 cases), and seven-step hepatic segmental block method (seven hepatic necrosis group, 10 cases). Compare the differences between the three groups of related clinical indicators. Results: There was no significant difference in intraoperative blood loss between the three groups (P> 0.05). However, the operation time, postoperative recovery of liver function, recovery of gastrointestinal function, incidence of complications, length of stay and other indicators Obviously superior to the group of hepatic block and hemi-hepatic block (all P <0.05). Conclusion: Laparoscopic hepatic lobectomy with seven-step hepatic resection is safe, simple and feasible. The laparoscopic technique is less demanding and suitable for hospitals at all levels.