关键词: 巨大肝癌切除术, 半肝血流阻断, 间歇性Pringle法, 出血量, 肝功能

Abstract: Objective To explore the application effect of hemihepatic blood flow occlusion combined with intermittent Pringle method in the resection of giant liver cancer. Methods From January 2019 to December 2021, seventy-eight patients with liver cancer who underwent giant liver cancer resection were selected from Suzhou Hospital affiliated to Nanjing Medical University. They were divided into a semihepatic group and an experimental group with thirty-nine cases in each group. The semihepatic group was treated with half hepatic blood flow occlusion, and the experimental group was treated with half hepatic blood flow occlusion in combination with intermittent Pringle method. The perioperative indicators of the experimental group and the semihepatic group were compared. The relevant indicators of liver function before operation and at 1 day, 3 days and 5 days after operation were detected and analyzed. The complications and quality of life within 3 months after operation [Quality of life measurement scale for liver cancer patients (QLI-LC score)] were counted. Results Compared with the semihepatic group, the experimental group had less intraoperative bleeding [(163.28±26.47) ml vs 198.24±34.15) ml] and shorter hospital stay [(8.15±1.20) d vs (9.58±1.36)d](P<0.05). The liver function indicators of the two groups increased at 1 day, 3 days and 5 days after operation and decreased thereafter (P<0.05). However, there was no difference in liver function parameters between the two groups at each time point (P>0.05). The incidence of complications in the experimental group was 7.69%, which was significantly lower than that of 25.64% in the semihepatic group (P<0.05). When compared the QLI-LC score at three and a half months after operation, the physical function (12.87±3.21), symptoms and signs (10.09±2.21), psychological function (7.09±1.92), and social function (9.27±1.04) in the experimental groups was lower than those of (21.38±4.98), (17.87±3.76), (13.15±2.03), and (14.28±2.75) respectively, in the semihepatic group (P<0.05). Conclusion The application of hemihepatic blood flow occlusion combined with intermittent Pringle method in the resection of giant liver cancer can reduce intraoperative bleeding, promote postoperative recovery, improve the quality of life with high safety, without aggravating the occurrence of liver injury and complications.

Key words: Resection of giant liver cancer, Hemihepatic blood flow occlusion, Intermittent Pringle method, Bleeding volume, liver function