腹腔镜肝切除治疗肝癌合并肝硬化的短期疗效  

Short-term efficacy of laparoscopic hepatectomy for treating hepatocellular carcinoma with cirrhosis

作　　者：王琦[1] 段键[1] 林杰[1] 黄汉飞[1] 徐王刚[1] 夏志超[1] 张伟鑫[1] 曾仲[1] 

机构地区：[1]昆明医科大学第一附属医院器官移植中心,云南省昆明市650032

出　　处：《世界华人消化杂志》2016年第12期1910-1915,共6页World Chinese Journal of Digestology

基　　金：云南省卫生科技计划基金资助项目;No.2014NS155~~

摘　　要：目的:探讨腹腔镜肝切除(laparoscopic hepatectomy,LH)与开腹肝切除(open hepatectomy,OH)治疗肝癌合并肝硬化患者短期疗效的差别.方法:回顾性分析2011-09/2014-12昆明医科大学第一附属医院器官移植中心收治的肝癌合并肝硬化患者病历资料56例,随机分为2组,其中LH组24例,OH组32例.对两组患者术中情况、术后恢复及术后短期复发情况进行对比分析.计量资料采用成组t检验和配对t检验,计数资料采用冇2检验.结果:两组患者基本情况相似,组间无明显统计学差异(均P>0.05);LH组和OH组手术时间分别为355.42 min±22.36 min和200.87min±18.59 min,术中出血量分别为117.26mL±57.17 mL和353.52 mL±80.63 mL,术后切口感染、胆漏、腹水等并发症LH组均显著低于OH组,术后前3 d肝功能水平(谷丙转氨酶、谷草转氨酶),住院时间和肿瘤短期复发LH组均显著低于OH组.结论:在肝癌合并肝硬化治疗方面,LH无论从术中情况、术后恢复及短期复发情况等均优于OH,具有较高临床意义.AIM：To compare the short-term efficacy of laparoscopic hepatectomy（LH） vs open hepatectomy（OH） for hepatocellular carcinoma with cirrhosis.METHODS：A retrospective analysis was performed of 56 patients with hepatocellular carcinoma and cirrhosis who were treated from September 2011 to December 2014 at our hospital.They were randomly divided into either an LH group（24 cases） or an OH group（32 cases）based on the mode of surgery.Intraoperative variables,postoperative recovery and shortterm postoperative recurrence were analyz ed and compared between the two groups.RESULTS：There were comparable demographic data（P 〉0.05） between the two groups.Operative time was 355.42 min ± 22.36 min for the LH group and 200.87 min ± 18.59 min for the OH group.Blood loss volume was 117.26 mL ± 57.17 mL for the LH group and 353.52 mL± 80.63 mL for the OH group.The incidence rates of postoperative infection,bile leakage and ascites were signifi cantly lower in the LH group than in the OH group.Levels of liver function（ALT,AST） within three days after operation,hospitalization,and short-term tumor recurrence rate were signifi cantly lower in the LH group than in the OH group.CONCLUSION：In the treatment of cirrhosis with liver cancer,LH is better than OH interms of operative time,intraoperative blood loss,postoperative recovery and short-term recurrence.

关 键 词：肝癌 肝硬化 肝切除术 腹腔镜 

分 类 号：R735.7[医药卫生—肿瘤] R575.2[医药卫生—临床医学]