3种不同术式治疗原发性大肝癌的疗效比较  

Clinical efficacy of three surgical methods in primary large hepatocellular carcinoma

作　　者：钟其焕 陈博艺[1] 余勇[1] 李荣[1] 李称才[1] 邓国荣[1] ZHONG Qi-huan;CHEN Bo-yi;YU Yong;LI Rong;LI Cheng-cai;DENG Guo-rong(Department of Hepatobiliary Surgery,Zhanjiang Central People’s Hospital,Zhanjiang 524045,China)

机构地区：[1]广东省湛江中心人民医院肝胆外科,广东湛江524045

出　　处：《广东医科大学学报》2020年第4期424-427,共4页Journal of Guangdong Medical University

摘　　要：目的探讨3种不同术式治疗原发性大肝癌(PLHC)的疗效。方法126例PLHC患者分别采用腹腔镜解剖性肝切除术(LAH)、腹腔镜非解剖性肝切除术(LNAH)和开腹肝切除术(OH),比较3组围手术期临床指标、肝功能指标、并发症、1 a总生存和无复发生存期。结果与LAH组相比,LNAH、OH组的手术时间较短,但术中失血量较多,术后入住重症监护室时间、腹腔引流管放置时间和住院时间均较长,下床活动迟,术后7 d丙氨酸氨基转移酶、天冬氨酸转氨酶和总胆红素水平较高(P<0.01或0.05),其中OH组最显著。LAH组1 a无复发生存期明显高于LNAH、OH组,而OH组总并发症发生率高于LAH、LNAH组(P<0.05)。结论LAH治疗PLHC效果最好,LNAH次之,OH最差。Objective To compare the clinical efficacy of three surgical methods in primary large hepatocellular carcinoma(PLHC).Methods A total of 126 PLHC patients underwent laparoscopic anatomical hepatectomy(LAH),laparoscopic non-anatomical hepatectomy(LNAH)or open hepatectomy(OH).The perioperative clinical indicators,liver function,complications,and 1-year overall survival and relapse-free survival(PFS)were compared among three groups.Results Compared with LAH group,operation time was shorter,while intraoperative blood loss,ICU time,abdominal drainage time,hospital stay,off-bed activity time,and serum levels of alanine and aspartate aminotransferases and total bilirubin 7 days postoperation were higher in LNAH and OH groups(P<0.01 or 0.05),especially in OH group.The 1-year PFS was higher in LAH group than in LNAH and OH groups,but overall complications were more common in OH group compared with LAH and LNAH groups(P<0.05).Conclusion LAH,LNAH,and OH are effective for PLHC in a decreasing order.

关 键 词：原发性大肝癌 腹腔镜 肝切除术 

分 类 号：R657.3[医药卫生—外科学]