腹腔镜与传统开放式肝脏切除术临床疗效对比研究  

Comparative Study of Clinical Efficacy of Laparoscopic Hepatectomy and Traditional Open Hepatectomy

作　　者：李少伟[1] 

机构地区：[1]武警北京总队医院外一科,北京100027

出　　处：《中国现代手术学杂志》2015年第2期94-98,共5页Chinese Journal of Modern Operative Surgery

摘　　要：目的研究腹腔镜在肝脏切除术中的安全性和可行性。方法回顾性分析我院2013年1月～2014年12月68例肝脏肿瘤切除患者的临床资料,其中腹腔镜组（LH组）29例、开腹组（OH组）39例,对比分析两组患者术中和术后情况。结果 LH组和OH组的手术切口长度分别为（5.46±0.16）cm vs.（23.52±0.12）cm（t=532.22,P=0.000）;手术时间分别为（198.63±27.63）min vs.（162.32±24.58）min（t=5.714,P=0.000）;术中出血量分别为（413.27±178.94）ml vs.（453.36±187.63）ml（t=0.889,P=0.378）;术中输血率分别为31.03%vs.28.21%（χ2=0.064,P=0.800）;术后并发症发生率分别为17.24%vs.17.95%（χ2=0.006,P=0.940）;术后肝功能指标LH组较OH组恢复快（P〈0.05）;LH组和OH组术后禁食时间分别为（1.64±0.73）d vs.（2.87±0.82）d（t=6.406,P=0.000）;术后引流管放置时间分别为（3.63±0.58）d vs.（6.32±0.72）d（t=16.517,P=0.000）;术后住院时间分别为（8.23±1.32）d vs.（11.37±1.47）d（t=9.093,P=0.000）。在远期并发症发生率、复发率、转移率和死亡率上LH组和OH组比较无显著差异（P〉0.05）。结论腹腔镜肝脏切除术安全、可行,具备创伤小、术后恢复快、痛苦小等优点,值得临床应用。Objective To discuss the safety and feasibility of laparoscopic liver resection. Methods A retrospective analysis was carried out on the clinical data of 68 cases undergone liver resection for the treatment of hepatocellular carcinoma in our hospital from January 2013 to December 2014. There were 29 cases in laparoscopic hapatectomy group（ LH group）,and 39 cases in open hapatectomy group（ OH group）. The intraoperative and postoperative conditions of these two groups were compared. Results In the LH group and OH group,the incision length were（ 5. 46 ± 0. 16） cm vs.（ 23. 52 ± 0. 12） cm（ t = 532. 22,P = 0. 000）; the operative time was（ 198.63 ±27.63） min vs.（ 162.32 ±24.58） min（ t =5.714,P =0.000）; the blood loss was（ 413.27 ±178.94） ml vs.（ 453. 36 ± 187. 63） ml（ t = 0. 889,P = 0. 378）; the intraoperative blood transfusion rate was 31. 03% vs.28. 21%（ χ2= 0. 064,P = 0. 800）; the incidence of postoperative complications was 17. 24% vs. 17. 95% respectively（ χ2= 0. 006,P = 0. 940）; the postoperative fasting time was（ 1. 64 ± 0. 73） d vs.（ 2. 87 ± 0. 82） d（ t =6.406,P =0.000）; the drainage tube placement time was（ 3.63 ± 0.58） d vs.（ 6.32 ±0.72） d（ t =16.517,P = 0. 000）; and the postoperative hospital stay was（ 8. 23 ± 1. 32） d vs.（ 11. 37 ± 1. 47） d（ t = 9. 093,P = 0. 000）.And the recovery of the postoperative liver function of LH group was quicker than the OH group（ P 〈0. 05）. The long-term complication rate,recurrence rate,metastasis and mortality was not significantly different between the two groups（ P 〉0. 05）. Conclusions Laparoscopic hepatectomy for the treatment of hepatic carcinoma is a safe and effective technique which can give full play to advantages of minimally invasion,quick recovery and less pain.

关 键 词：腹腔镜检查 肝切除术 

分 类 号：R735.7[医药卫生—肿瘤]