腹腔镜肝切除与开腹肝切除治疗巨大肝脏海绵状血管瘤的临床对照研究  

Comparison of therapeutic effect of laparoscopic hepatectomy and open hepatectomy for giant hepatic cavernous hemangiomas

作　　者：范瑞芳 肖毅 许树林 汤志鹏 党政 上官建营 吕志诚 张超 秦建伟 王湘辉 FAN Ruifang;XIAO Yi;XU Shulin;TANG Zhipeng;DANG Zheng;SHANGGUAN Jianying;LV Zhicheng;ZHANG Chao;QIN Jianwei;WANG Xianghui(Department of Hepatobiliary Surgery,Lanzhou General Hospital of PLA,Lanzhou 730050,China)

机构地区：[1]解放军兰州总医院肝胆外科,甘肃兰州730050

出　　处：《西北国防医学杂志》2018年第11期744-747,共4页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的:比较分析腹腔镜肝切除术(laparoscopic hepatectomy,LH)与开腹肝切除术(open hepatectomy,OH)治疗巨大肝脏海绵状血管瘤(hepatic cavernous hemangioma,HCH)的疗效及并发症。方法:选取我科2013-08～2018-08单病灶直径>10cm的HCH患者62例,20例患者实施LH治疗(LH组),42例患者实施OH治疗(OH组)。患者均有明显上腹部症状或瘤体快速增大,术前经超声、螺旋CT及MRI检查获得确诊。结果:LH组术中出血量、输血率、术后住院时间及并发症发生率均明显低于OH组(均P<0.01)。所有病例术后均出现血清ALT及AST一过性升高。随访1～30个月(中位19个月),两组均未见残留病灶,肝功能恢复良好,腹部症状消失。结论:外科切除是治疗巨大HCH最有效的方法。LH具有微创、恢复快、住院时间短、并发症少等优点,最适用于肝左外叶的HCH。Objective:To compare the therapeutic efficacy and complications of laparoscopic hepatectomy (LH) with open hepatectomy (OH) for patients with giant hepatic cavernous hemangiomas (HCH).Methods:Between August 2013and August 2018,a total of 62 giant HCH patients with single liver lesions were treated by LH (LH group,n=20) or OH (OH group,n=42).The obvious abdominal symptom or rapid tumor development was observed in all patients.Preoperative diagnosis of HCH was established by means of ultrasound,helical computed tomography (CT) scans and magnetic resonance imaging (MRI).Results:The intraoperative blood loss and blood transfusion rate,the postoperative hospitalization and complications rate in LH group were lower than those in OH group(P<0.01).The transient elevation of serum ALT and AST levels were observed postoperatively in all patients.At a median follow-up of 19months (range 1-30months),no remnant tumor tissue was found,the liver function was recovered and the abdominal symptoms were disappeared in both groups.Conclusion:Surgical resection is still the most effective method in the treatment of giant HCH.LH is a minimally invasive treatment method for giant HCH,with rapid recovery,shorter hospital stay and fewer complications,suitable for patients with giant HCH in left lateral lobe of liver.

关 键 词：肝脏 海绵状血管瘤 腹腔镜 外科切除术 

分 类 号：R735.7[医药卫生—肿瘤]