腹腔镜下不同术式治疗肝包虫病的临床疗效对比研究  

Comparative study of clinical effect of three different laparoscopic surgical treatment on hepatic hydatidosis

作　　者：谭琴 母齐鸣 杨娟[1] 贺伟[1] Tan Qin;Mu Qiming;Yang Juan;He Wei(Department of Hepatobiliary surgery,363 Hospital of Air China Industry Chengdu 610041)

机构地区：[1]中航工业三六三医院肝胆外科,成都610041

出　　处：《中华普外科手术学杂志（电子版）》2020年第2期186-188,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：四川省医学科研计划项目(S15003)。

摘　　要：目的探讨腹腔镜下不同术式治疗肝包虫病的临床疗效和随访结果。方法回顾性分析2013年1月至2018年4月行腹腔镜手术治疗的76例肝包虫病患者的临床资料。其中A组(行腹腔镜肝包虫外囊完整剥除术)患者23例,B组(行腹腔镜肝包虫内囊摘除术)患者25例,C组(行腹腔镜解剖性肝切除术)患者28例。应用SPSS20.0统计学软件进行数据处理,围术期各项指标用(x±s)表示,多组间采用单因素方差分析,组间两两比较用t检验;术后并发症和1年复发率行χ^2检验;P<0.05表示差异有统计学意义。结果 C组患者的手术时间、术中出血量明显高于A组和B组(P<0.05);B组患者的拔管时间和住院时间明显长于A组和C组(P<0.05);B组胆漏、残腔积液、残腔感染发生率明显高于C组(P<0.05);术后随访发现B组患者术后复发3例(12.5%),其余两组患者均无复发病例,差异有统计学意义(P<0.05)。结论腹腔镜外囊完整剥除术和腹腔镜解剖性肝切除术均安全可靠,术后复发率低。腹腔镜解剖性肝切除术有利于患者术后恢复,并发症发生率低,可作为治疗肝包虫病的主要手术方式。Objective To investigate the clinical efficacy and follow-up results of three different laparoscopic procedures for hepatic hydatidosis. Methods The clinical data of 76 patients with hepatic hydatidosis treated with laparoscopic surgery in our hospital from January 2013 to April 2018 were retrospectively analyzed. There were 23 patients in group A(who underwent complete removal of hepatic hydatid cysts by laparoscopy), 25 patients in group B(who underwent laparoscopic removal of internal hepatic hydatid cysts) and 28 patients in group C(who underwent laparoscopic anatomical hepatectomy). SPSS20.0 statistical software was used for data processing. Perioperative data of each group were compared. Single factor analysis of variance was used among groups, LSD-t test was used for comparison between groups, and χ^2 test was used for complications and recurrence after follow-up. P<0.05 indicated the difference was statistically significant. Results The operation time and bleeding volume in group C were significantly higher than those in group A and group B(P<0.05);the extubation time and hospitalization time in group B were significantly longer than those in group A and group C(P<0.05);the incidence of bile leakage, residual fluid and residual infection in group B was significantly higher than those in group C(P<0.05). Postoperative recurrence was found in 3 cases(12.5%) and no recurrence was found in the other two groups(P<0.05). Conclusion Both laparoscopic removal of hepatic hydatid cysts by laparoscopy and laparoscopic anatomical hepatectomy were safe and reliable, and the recurrence rate was low. The laparoscopic anatomic hepatectomy is helpful to the postoperative recovery of the patient and reduces the recurrence rate, which can be used as the main surgical method for the treatment of the hepatic hydatidosis.

关 键 词：棘球蚴病 肝 腹腔镜 肝切除术 内囊 疗效比较研究 

分 类 号：R657.3[医药卫生—外科学]