肝脏海绵状血管瘤剥离术及组织解剖学基础-中华普通外科学文献.PDFVIP

194 中华普通外科学文献 （电子版）20 10 年 ６月第 4 卷第 3 期 Chin Arch Gen Surg （Electronic Edition ），June 20 10 ，Vol 4 ，No.3 · · · 论著 · 肝脏海绵状血管瘤剥离术及组织 、 解剖学基础 李国威 杨 少毅 【摘要】 目的 探讨剥离术治疗肝海绵状血管瘤 （CHL ）手术方法及其相关组织学、 解剖学基础 。 方法 术 中导管插至肝内Ⅱ级动脉 ， 直接供血动脉造影； 观察瘤体超微结构； 肝叶切除， 风干标本横切面 观察及剥离新鲜标本观察瘤体与瘤床关系。 临床治疗11例。 结果 瘤前均有约1 mm的供血小动脉， 可供 方便结扎 。瘤体 内无肝小叶结构， 证实CHL无 门静脉供血及形成胆管 的组织学基础。手术标本证实瘤体 与瘤床间除供血小动脉外无任何粘连。 结论 手术剥离瘤体安全性高， 无需切除肝组织， 术中无大出血， 术后无胆漏发生。可适用于肝脏各 叶内血管瘤。安全性远高于肝叶切除治疗CHL 。 【关键词】 海绵状血管瘤， 肝脏； 组织学； 解剖学； 剥离术 Enucleation and histologic and anatomical characteristics for cavernous hemangioma of the liver LI Guo-wei, YA NG Shao-yi. Dep artment of General Surgery, the Second Aff iliated Hosp ital, X i鸳an Jiaotong Uni原 vers ity, X i鸳an 710004, China Corresp onding author: L i Guo-we i , Email: liguowei1964 @ 【Abstra ct 】 Objective To explore enucleation and histologic and anatomical characteristics for cav- ernous hemangioma of the liver. Methods The clinical data of 11 patients with hepatic cavernous hemangioma were analyzed retrospectively. Serial selective hepatic arteriography was performed. Samples of hepatic cavernous hemangioma were prepared to examine using transmission electron microscopy. Results Blood supply of hepatic cavernous hemangioma might only originate from the hepatic artery. There were no hepatic lobules and biliary duct in hepatic cavernous hemangioma. Conclusions Cavernous hemangiomas of the liver can be removed more safely by enucleation than by hepatic resection. Enucleation is associated with fewer intra-abdominal complications such as bile leakage and massive bleeding. 【Key words 】Liver, Cavernous hemangioma; Histology; Anatomy; Enucleation 肝脏海绵状血管瘤 （caver