微波消融与腹腔镜肝切除术对肝血管瘤患者VAS及肝功能的影响  

Effect of microwave ablation and laparoscopic hepatectomy on visual analogue scale score and liver function in patients with hepatic hemangiomas

作　　者：肖莉[1] Li Xiao(Department of Hemangioma, He＇nan Province People＇s Hospital, Zhengzhou 450003, He＇nan Province, Chin)

机构地区：[1]河南省人民医院血管瘤科,河南省郑州市450003

出　　处：《世界华人消化杂志》2018年第8期500-505,共6页World Chinese Journal of Digestology

摘　　要：目的探讨微波消融与腹腔镜肝切除术对肝血管瘤患者视觉模拟评分(visual analogue scale,VAS)及肝功能的影响.方法选择2014-06/2016-12于河南省人民医院确诊肝血管瘤并选择手术治疗的患者79例,按照随机数字表法分为研究组(n=41例)及对照组(n=38例),研究组给予微波消融术进行治疗,对照组给予腹腔镜下部分肝切除术,然后记录两组患者手术用时、术中出血量、术后不良反应、住院总时间及术后12、24、48 h的VA S得分情况并进行对比,分别于术后1 d及3 d抽静脉血检查患者肝功能[谷丙转氨酶(alanine transaminase,ALT)及谷草转氨酶(aspartate transaminase,AST)]相关指标并进行对比.结果研究组患者手术时间低于对照组(38.63 min±11.74min vs 187.21 min±78.85 min,术中出血量低于术中出血量20.52 mL±7.45 mL vs 329.72 mL±104.63mL,P<0.01).两组患者住院时间比较没有明显差异.研究组术后不良反应发生率(3%)明显低于对照组(36.8%)(P<0.01).研究组患者术后12、24及48 h时的VAS得分均明显低于对照组(P<0.01).研究组术后1 d的ALT及AST值明显高于对照组(P<0.05).两组患者术后3 d的ALT及AST值没有明显差异.结论微波消融术治疗肝血管瘤患者效果显著,且在缩短手术时间、降低术中出血量、减少术后VAS评分的同时,还能够有效避免患者肝损伤,且安全性较好.AIM To investigate the effect of microwave ablation and laparoscopic hepatectomy on visual analogue scale（VAS）score and liver function in patients with hepatic hemangiomas METHODS A total of 79 patients diagnosed with hepatic hemangioma and would undergo surgery at our hospital from June 2014 to December 2016 were chosen and randomly divided into either a study group（n = 41）or a control group（n = 38）.The study group underwent microwave ablation,while the control group underwent laparoscopic partial hepatectomy.Surgical time,intraoperative blood loss,adverse reactions,total hospital stay time,and VAS scores at 12 h,24 h,and 48 h after surgery were recorded and compared between the two groups.The indexes of hepatic function[alanine aspartate transaminase（AST）]were also compared.transaminase（ALT）and at I d and 3 d after surgery Both surgical time and intraoperative blood loss were significantly lower in the study group than in the control group（38.63 min ± 11.74 min vs 187.21 min± 78.85 min,20.52 mL± 7.45 mL vs 329.72 mL ± 104.63 mL,P 〈 0.01）.There was no significant difference in hospitalization time between the two groups.The adverse reaction rate（3%）in the study group was significantly lower than that in the control group（36.8%）（P 〈 0.01）.The VAS scores of the study group at 12 h,24 h,and 48 h after surgery were significantly lower than those of the control group（P 〈 0.01）.The ALT and AST in the study group at I d after surgery were significantly higher than those in the control group（P 〈 0.05）,although there was no significant difference in ALT and AST between the two groups at 3 days after surgery.CONCLUSION Microwave ablation can shorten surgical time,reduce intraoperative blood loss and postoperative VAS score,improve ALT and AST levels,and effectively prevent liver injury in patients with hepatic hemangiomas with good safety.

关 键 词：肝血管瘤 微波消融 腹腔镜 VAS评分 肝功能 

分 类 号：R735.7[医药卫生—肿瘤]