关键词: 原发性肝癌, 血流阻断, 肝叶切除术, 生存

Abstract: Objective To investigate the efficacy of different hepatic inflow occlusion in hepatectomy in treatment of patients with primary large liver cancer. Method 172 patients with primary large liver cancer in our hospital and in Second Hospital affiliated to Dalian Medical University between May 2014 and May 2016 were divided into three groups according to the different methods of blood flow occlusion during hepatectomy. 52 cases received portal occlusion,44 cases received hemihepatic occlusion,and 76 cases received combination occlusion. The relevant clinical parameters among the three groups were compared. Results There was no significant differences in baseline data among the three groups （P>0.05）;there was no significant differences in blocking time, operation time and hepatic resection volumes among the three groups（P>0.05）;the amounts of bleeding in portal occlusion group was（736.38±498.36） ml,much more excessive than[（472.56±111.89） ml in hemihepatic occlusion group or （356.14±132.53） ml in combination occlusion group,P<0.05],and the blood transfusion volumes in portal occlusion group was （586.54±132.58）ml,much more massive than [（427.95±210.47） ml in hemihepatic occlusion group or（184.38±72.54） ml in combination occlusion group,P<0.05];7 days after operations,serum ALT level in portal occlusion group was（73.02±43.41）U/L,much higher than[（55.89±40.82） U/L in hemihepatic occlusion group,or （52.01±33.81） U/L in combination occlusion group （P<0.05）;there was no significant differences as respect to complication rate among the three groups（P>0.05）;the 1 a survival rate in combination group was 96.1% and the tumor relapse rate was 2.6%,much lower than 75.0% and 15.4% in portal occlusion group or 68.2% and 20.5%,respectively,in hemihepatic occlusion group（P<0.05）. Conclusion The application of Pringle method combined with inferior vena cava occlusion in blocking hepatic blood flow during hepatectomy in treatment of patients with primary large liver cancer can effectively reduce the amount of intraoperative bleeding,improve recovery,and might increase survivals.

Key words: Hepatoma, Hepatectomy, Hepatic inflow occlusion, Survival