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不同肝血流阻断方法对可手术小肝癌预后的影响

Comparison of Different Methods of Vascular Occlusion in Hepatectomy on Prognosis of Operable Small Liver Cancer Patients

  • 摘要: 目的 比较可手术小肝癌选择性适时半肝血流阻断法与肝十二指肠韧带阻断法(Pringle法)对患者中长期生存的影响。方法 根据肝血流阻断不同方式,将我院腹部外科222例小肝癌手术患者分为无肝门阻断、选择性适时半肝血流阻断与Pringle法3组,对以上患者进行随访,收集生存资料进行分析比较。结果 选择性适时半肝血流阻断组与无肝门阻断和Pringle法组患者之间中位生存时间差异有统计学意义(P值分别为0.02、0.04)。无肝门阻断、选择性适时半肝血流阻断和Pringle法组患者3年生存率分别为81.3%、93.3%和76.0%,三者间差异有统计学意义(P=0.008);5年生存率分别为70.6%、90.8%和50.7%,三者间差异有统计学意义(P<0.001)。选择性适时半肝血流阻断组3年生存率与5年生存率均优于其他两组。结论 在小肝癌可手术患者中应用选择性适时半肝血流阻断较Pringle法能显著延长患者的生存时间,提高患者生存率。

     

    Abstract: Objective To compare the effect of selectively timely half hepatic vascular occlusion and Pringle maneuver in hepatectomy on long-term survival of patients with operable small liver cancer. Methods According to various hepatic vascular occlusion methods, we divided 222 patients with small liver cancer who received the abdominal surgery in our hospital into three groups: No hepatic vascular occlusion group, selectively timely half hepatic vascular occlusion group and Pringle maneuver group. We periodically followed the patients up to collect and compare survival data. Results The median survival time of selectively timely half hepatic vascular occlusion group had statistical significant difference with No hepatic vascular occlusion and Pringle maneuver groups, respectively (P=0.02 and P=0.04). The 3-year survival rate of No hepatic vascular occlusion, selectively timely half hepatic vascular occlusion and Pringle maneuver groups were 81.3%, 93.3% and 76.0%, respectively (P=0.008); The 5-year survival rates were 70.6%, 90.8% and 50.7%, respectively (P<0.001). The 3- and 5-year survival rates of selectively timely half hepatic vascular occlusion group were better than the other two groups. Conclusion Selectively timely half hepatic vascular occlusion in hepatectomy on small liver cancer patients could significantly improve the survival rate and prolong the survival time.

     

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