【摘要】 目的 :探讨肝切除术在肝脏良性占位性病变治疗中的价值及特点。方法 :回顾性分析本院 1994年 1月至 2 0 0 0年 8月行肝切除术治疗的 47例肝脏良性占位性病变患者的临床资料 ,其中肝血管瘤 2 6例 ,肝囊肿 7例 ,肝炎性假瘤 3例 ,右肝错构瘤、肝脏平滑肌瘤、肝结核瘤和炎性肉芽肿各 2例 ,肝细胞腺瘤、右肝上皮样血管内皮瘤和肝右后叶结节性坏死各 1例。结果 :共行肝左外叶切除术 18例 ,肝左或右叶瘤体局部切除术 14例 ,右后叶切除或部分切除术 8例 ,右半肝切除术 3例 ,右前叶部分切除术 2例 ,左半肝切除术和胰头异位肝囊肿切除术各 1例。 9例术中预置全肝血流阻断带 ,2例应用自体血回输。 5例术后发生右侧胸腔积液、切口感染、膈下感染、胆漏等并发症。 47例全部治愈。结论 :对于多数有症状、体积较大或怀疑恶变之肝脏良性占位性病变 ,肝切除术是主要的治疗手段 ,而且安全有效 ;借助术中或术后病理检查可明确诊断 ;术中应用全肝血流阻断和自体血回输可提高困难手术的安全性。更多还原

【Abstract】 Objective To explore the value of hepatectomy in treating benign occupied disease of the liver.Method A retrospective study was made on the clinical data of 47 patients with hepatic benign occupied disease who underwent hepatectomy from January 1994 to Augest 2000.Of all the patients,there were 26 cases of liver hemangioma,7 liver cyst,3 inflammatory pseudotumor of the liver,11 other benign liver diseases (including hepatic tuberculoma,hepatic adenoma and liver hamartoma, etc.).Results Hepatectomy was performed on left lateral lobes (n=18),tumor region of the left or right lobes (n=14),total or partial right posterior lobes (n=8),right half liver (n=3),partial right anterior lobes (n=2),left half liver (n=1) and heterotopic liver cyst on pancreatic head (n=1),respectively.Occluding tapes for total blood flow were applied to 9 cases before hepatectomy,and autotransfusions to 2 cases during operation.Postoperative complications including subphrenic infection and biliary leak occurred in 5 patients.All the 47 patients were cured.Conclusions For most benign occupied diseases of the liver with symptoms or suspicious malignancy,hepatectomy safe and effective is the main method of therapy as well as diagnosis.Complete hepatic vascular occlusion and autotransfusion can improve the safety of hepatectomy.更多还原