文档介绍：1 肝脏巨大海绵状血管瘤的外科治疗作者: 张洪义孔亚林张宏义何晓军张辉刘承利肖梅张希东【摘要】目的: 探讨肝脏巨大海绵状血管瘤( cavernous haemangioma of liver, CHL ) 的外科治疗适应证并总结治疗经验。方法:对 15 例特大 CHL 患者的临床资料进行回顾性分析。结果: 9 例患者接受血管瘤剥离术治疗,术后恢复顺利; 6 例患者行肝动脉栓塞治疗,其中 2 例患者接受了择期根治性切除手术。结论:巨大 CHL 可能引起严重的临床症状,可以结合肝功能分级和全身情况选择包括剥离术、肝动脉栓塞在内的综合性方法。【关键词】血管瘤,海绵状· 肝肿瘤· 外科手术【 ABSTRACT 】 Objective : To investigate the surgical indication and effect of surgical treatment for giant cavernous hemangioma of the liver(LHG). Methods : The clinical data, including selection of operations, management for severe 2 operative bleeding and postoperative supplementary treatment, of 15 patients with giant LHG treated by surgical measures from 2003 in our hospital were summarized and assessed. Results : Nine cases accepted decollement of LHG, and the recovery courses were all right, 6 cases accepted embolization of hepatic artery, in which 2 cases accepted operation afterward. Conclusions : Decollement or embolization of hepatic artery were effective in the treatment of giant cavernous hemangioma. 【 KEY WORDS 】 Hemangioma, cavernous · Liver neoplasms · Surgical procedure, operative 肝海绵状血管瘤( cavernous haemangioma of liver, CHL ) 是最为常见的肝脏肿瘤,传统观点认为其为良性疾病, 发展缓慢,对机体影响小,故主张动态观察[ 1] 。但是在部分患者, CHL 可呈进行性生长, 逐渐侵犯和破坏周围正常肝组织, 至患者因上腹不适等非特异性症状就诊时, 瘤体已巨大, 并且常伴有不同程度的肝功能异常, 大大增加了外科治疗的难度。我院自 2003 年以来共收治 15 例瘤体直径≥ 20cm 的特大 CHL 患者,针对肿瘤的发生部位、生长特点、对机体影响的情况进行了包括不同血流阻断条件下的包膜外血管瘤切除、结合动脉栓塞术的根治性治疗在内的综