Ⅳ型肝门部胆管癌治疗中腹腔镜辅助下切除手术的临床应用分析  

Clinical Application Analysis of Laparoscopic-assisted Resection in the Treatment of Type Ⅳ Hilar Cholangiocarcinoma

作　　者：臧唯 徐丹妮 汪大洋[2] ZANG Wei;XU Danni;WANG Dayang(Department of Hepatobiliary Surgery,Jilin Central Hospital,Jilin,Jilin Province,132000 China;College of Chemistry,Jilin University,Changchun,Jilin Province,130000 China)

机构地区：[1]吉林市中心医院肝胆外科,吉林吉林132000 [2]吉林大学化学学院,吉林长春130000

出　　处：《中外医疗》2021年第27期29-32,共4页China & Foreign Medical Treatment

基　　金：吉林省卫生计生科研课题(2014Q002);“吉林重大科技专项”项目;国家重点实验室(吉林大学)开放课题项目(2018jlu001)。

摘　　要：目的分析Ⅳ型肝门部胆管癌治疗中腹腔镜辅助下切除手术的临床应用价值。方法方便选取2019年4月—2020年4月该院收治的60例Ⅳ型肝门部胆管癌患者作为研究对象,对其临床资料进行回顾性分析,根据其手术方法的不同将其分为对照组和研究组,每组30例。对照组采用开腹根治性切除术治疗,研究组采用腹腔镜辅助下切除手术治疗,比较两组手术时间、术中出血量、术后下床时间、住院时间、并发症率以及RO切除率差异。结果研究组手术时间(486.75±50.33)min,长于对照组(357.42±35.78)min,差异有统计学意义(t=11.471,P<0.05)。研究组术中出血量(188.35±55.72)mL,低于对照组(355.91±78.41)mL,差异有统计学意义(t=9.541,P<0.05)。研究组下床时间为(1.66±0.43)d,短于对照组(2.97±0.51)d,差异有统计学意义(t=10.756,P<0.05)。研究组住院时间为(7.84±1.56)d,短于对照组(11.93±1.94)d,差异有统计学意义(t=8.999,P<0.05)。研究组并发症发生率为6.67%,低于对照组26.67%,差异有统计学意义(χ^(2)=4.320,P<0.05)。研究组RO切除率为90.00%,高于对照组60.00%,差异有统计学意义(χ^(2)=7.200,P<0.05)。结论在Ⅳ型肝门部胆管癌患者的临床治疗中,腹腔镜辅助下切除手术具有良好临床应用价值,虽然手术时间较长,但是可以减少术中出血量,且不仅可进一步促进患者康复,减少并发症,而且还能够进一步提高肝门部胆管癌的根治性切除率。Objective To analyze the clinical application value of laparoscopic-assisted resection in the treatment of type Ⅳ hilar cholangiocarcinoma.Methods 60 patients with type Ⅳ hilar cholangiocarcinoma treated in the hospital from April 2019 to April 2020 were conveniently selected as the research object.Their clinical data were retrospectively analyzed.According to their different surgical methods,they were divided into control group and study group,with 30 cases in each group.The control group was treated with open radical resection and the study group was treated with laparoscopic assisted resection.The operation time,intraoperative bleeding,postoperative out of bed time,hospital stay,complication rate and RO resection rate were compared between the two groups.Results The operation time of the study group was(486.75±50.33)min,which was longer than that of the control group(357.42±35.78)min,the difference was statistically significant(t=11.471,P<0.05).The intraoperative blood loss in the study group was(188.35±55.72)mL,which was lower than the control group(355.91±78.41)mL,the difference was statistically significant(t=9.541,P<0.05).The time to get out of bed in the study group was(1.66±0.43)d,which was shorter than the control group(2.97±0.51)d,and the difference was statistically significant(t=10.756,P<0.05).The hospital stay in the study group was(7.84±1.56)d,which was shorter than the control group(11.93±1.94)d,and the difference was statistically significant(t=8.999,P<0.05).The complication rate of the study group was 6.67%,which was lower than the 26.67%in the control group,and the difference was statistically significant(χ^(2)=4.320,P<0.05).The RO resection rate in the study group was 90.00%,which was higher than the 60.00% in the control group,the difference was statistically significant(χ^(2)=7.200,P<0.05).Conclusion In the clinical treatment of patients with type Ⅳ hilar cholangiocarcinoma,laparoscopic-assisted resection has good clinical application value.Although the operation time is long

关 键 词：Ⅳ型肝门部胆管癌 腹腔镜辅助下切除手术 并发症 应用价值 

分 类 号：R256.4[医药卫生—中医内科学]