目的:探讨Pringle法联合左肝静脉阻断对左半肝切除术患者术中出血量及凝血指标的影响.方法:以2017年10月-2020年10月经本院收治行腹腔镜左半肝切除术82例患者病历资料做回顾性分析,循阻断方式差异实施分组,以Pringle法作对照组,以Pringle法联合左肝静脉阻断作观察组,比较两组基线资料、临床参数、凝血指标及并发症状况.结果:两组阻断时间、手术时间比较,差异无统计学意义(P>0.05),观察组术中出血量及住院时间均较对照组少或短(P<0.05);两组术后PT、APTT均稍有上升,TT及Fbg则呈一定程度下降,观察组PT、APTT、TT及Fbg变化幅度均低于对照组(P<0.05);两组并发症总发生率比较,差异无统计学意义(P>0.05).结论:左半肝切除术患者应用Pringle法联合左肝静脉阻断有助于降低术中出血量,缩短住院时间,且凝血功能影响较低,并发症发生率较低.
目的 探讨产甲胎蛋白胃癌(AFPGC)的临床特点和预后情况.方法 回顾性分析近三年厦门市中医院肝外科收治的5例产甲胎蛋白胃癌患者的临床资料,所有患者均经胃镜及组织病理明确诊断,随访其预后情况.结果 4例患者发现时伴肝转移,2例误诊,3例手术患者术后甲胎蛋白降至正常,生存时间4~14个月.结论 产甲胎蛋白胃癌恶性度高,发生肝转移或腹腔转移率高,容易误诊,预后不良.治疗上采用胃癌根治术,如伴有肝脏单发转移则并行肝转移瘤切除,配合术后化疗,无法手术切除的肝脏转移病灶考虑可行射频消融或局部动脉化疗栓塞治疗.
目的分析在超声引导下射频消融治疗肝穿刺后出血的临床意义。方法对2例接受超声引导下射频消融治疗肝穿刺后出血患者的临床资料做回顾性分析。结果2例患者肝穿刺后均出现失血性休克，采用在超声引导下行射频消融凝固止血，出血得到控制。结论射频消融治疗肝穿刺后的出血创伤小，操作简单，副反应轻，止血效果确切，临床可作为保守或手术治疗外的补充方法。
目的 探讨非肝脏病变误诊为肝占位性病变的原因及该类疾病的临床特点.方法 回顾性分析术前误诊为肝占位性病变,术后经病理确诊为非肝脏病变5例患者的临床资料.结果 5例均因体检时影像学检查发现肝占位性病变入院,均采取手术切除,术后病理检查提示1例为子宫内膜癌膈肌转移,1例为右肾上腺皮质腺癌,1例为右肾上腺嗜铬细胞瘤,2例为脾种植.结论 术前影像学提示肝内占位性病变者不能排除非肝脏病变,临床表现不典型者容易误诊.不能排除恶性占位性病变者建议手术切除,术后病理检查可以明确诊断.
Objective To observe the short-term effects of Chinese Medicine Gan-tai mixture (肝泰合剂) in combination with radiofrequency ablation to treat HCC. Methods 74 patients with HCC Ⅱ, Ⅲ stage were reviewed. The patients were divided into two groups randomly, 38 patients given Gan-tai mixture (肝泰合剂) in combination with radiofrequency ablation in treatment group, and 36 patients given Glutathione in combination with radiofrequency ablation in control group respectively. Results In comparison with control group, the ther-apy efficiency of treatment group(CR+PR)71.05% was strikingly higher than control group 58.33%(P<0.05). Besides, the decreasing rate of AFP in treatment group was also more obvious than control group (P<0.01). Further more, the main clinical symptoms of treatment group ameliorated much better than control group(P<0.01). Finally, after 12-month and 24-month therapy the survival rate of treatment group was higher than con-trol group conspicuously(P<0.05). Conclusion Gan-tai mixture (肝泰合剂) in combination with radiofre-quency ablation could not only ameliorate clinical symptoms of patients effectively, but also enhance immunity function of cells, and improve life quality and life span. In summary, it could serve as one of the effective thera-pies for treatment of advanced HCC patients.
