腹腔镜解剖性肝切除术在原发性肝癌治疗中的临床应用研究  

Research on the clinical application of laparoscopic anatomical hepatectomy in the treatment of primary liver cancer

作　　者：卢智略 王锦祥[1] 李晓辉[1] 刘特彬[1] 张建[1] LU Zhilve;WANG Jinxiang;LI Xiaohui;LIU Tebin;ZHANG Jian(Department of General Surgery,Pu'ning People's Hospital,Guangdong,Pu'ning 515300,China)

机构地区：[1]广东省普宁市人民医院普外科,广东普宁515300

出　　处：《中国医药科学》2021年第8期196-199,共4页China Medicine And Pharmacy

基　　金：广东省揭阳市科技计划项目(2019ws026)。

摘　　要：目的探究腹腔镜解剖性肝切除术在原发性肝癌治疗中的临床应用研究。方法选取2018年10月至2019年7月在普宁市人民医院确诊的98例原发性肝癌患者,采用随机数字表法分为观察组和对照组,每组各49例。对照组患者采用腹腔镜下非解剖性肝切除术,观察组患者采用腹腔镜下解剖性肝切除术。比较两组患者术中情况、术后并发症、术后两组患者肝功能及随访情况。结果观察组患者术中出血量、输血量、手术时间均明显少于对照组,差异有统计学意义(P<0.05);术后观察组患者并发症总发生率为4.08%,低于对照组的10.20%,差异有统计学意义(P<0.05);术后观察组患者谷丙转氨酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)等肝功指标均明显低于对照组,差异有统计学意义(P<0.05);随访发现,观察组患者未出现死亡病例,肝内复发率为2.04%,无肝外转移,根治率为97.96%;对照组患者死亡率为2.04%,肝内复发率为4.08%,肝外转移率为2.04%,根治率为91.84%,差异有统计学意义(P<0.05)。结论腹腔镜解剖性肝切除术在原发性肝癌治疗中的临床应用中具有恢复快、并发症少、住院时间短的优点,相对于传统腹腔镜非解剖性肝切除术具有较好疗效,值得推广。Objective To investigate the clinical application of laparoscopic anatomical hepatectomy in the treatment of primary liver cancer.Methods A total of 98 patients with primary liver cancer diagnosed in Pu’ning People’s Hospital from October 2018 to July 2019 were selected as research objects,and they were divided into the observation group(n=49)and the control group(n=49)according to random number table method.Among them,patients in the control group were treated with laparoscopic non-anatomical hepatectomy,while those in the observation group were treated with laparoscopic anatomical hepatectomy.The intraoperative condition and incidence of postoperative complications of the two groups were observed,and the postoperative hepatic function of the two groups of patients were compared.Results The intraoperative hemorrhage volume,blood transfusion volume and operation duration in the observation group were significantly shorter than those in the control group,with statistically significant differences(P<0.05).The total incidence of complications in the observation group was 4.08%,significantly lower than 10.20%in the control group,with statistically significant difference(P<0.05).After operation,hepatic function indexes such as ALT,AST and TBIL in the observation group were all obviously lower than those in the control group,with statistically significant differences(P<0.05).During the follow-up,there was no death in the obs ervation group,the relaps e rate in liver was 2.04%.Meanwhile,there was no extrahepatic metastasis,and the radical cure rate was 97.96%.In the control group,the mortality rate was 2.04%,the intrahepatic relapse rate was 4.08%.In addition,the extrahepatic metastasis rate was 2.04%,and the radical cure rate was 91.84%,with statistically significant difference(P<0.05).Conclusion Laparoscopic anatomical hepatectomy has the advantages of rapid recovery,low complications and short hospitalization time in the treatment of primary liver cancer.Compared with conventional laparoscopic non-anatomical hepa

关 键 词：腹腔镜 解剖性肝切除术 原发性肝癌 非解剖性肝切除 预后 

分 类 号：R735.7[医药卫生—肿瘤]