实时超声导航下解剖性肝段切除应用于原发性肝癌治疗中的价值  

The value of real-time ultrasound-guided anatomical segmental hepatectomy in the treatment of primary liver cancer

作　　者：刘凯 彭江 何自力[1,2] Liu Kai;Peng Jiang;He Zili(Department of Biliary Surgery,Hunan Provincial People′s Hospital(the First Affiliated Hospital of Hunan Normal University),Changsha 410000,China;Hepatobiliary Molecular Oncology Laboratory,Hunan Provincial People′s Hospital,Changsha 410000,China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)胆道外二科,长沙410000 [2]湖南省人民医院肝胆分子肿瘤实验室,长沙410000

出　　处：《中国医师杂志》2022年第2期212-215,共4页Journal of Chinese Physician

摘　　要：目的探讨应用实时超声导航下解剖性肝段切除治疗原发性肝癌患者的临床价值与意义。方法回顾性选取湖南省人民医院2015年1月至2017年10月收治的原发性肝癌患者43例作为对照组,选取2017年11月至2019年12月收治的原发性肝癌患者43例作为观察组。对照组应用不规则肝切除术治疗,观察组应用实时超声导航下解剖性肝段切除术治疗。比较不同方式治疗后两组患者手术情况、术后并发症发生率及生活质量评分。结果观察组肝门阻断率及输血率(13.9%,9.3%)均显著低于对照组(30.2%,25.5%,均P<0.05);观察组手术操作时间为(153.4±14.2)min,明显长于对照组[(127.3±12.1)min,P<0.05];观察组术后一年复发率(9.3%)明显低于对照组(30.2%,P<0.05),且观察组存活率(81.4%)明显高于对照组(51.2%,P<0.05)。结论应用实时超声导航下解剖性肝段切除术治疗原发性肝癌者可显著降低患者肝门阻断率与输血率,术后并发症发生率较低,对促进患者术后肝功能恢复、提升生活质量并降低疾病复发率均具有积极重要的意义。Objective To discuss the clinical value and significance of real-time ultrasound-guided anatomical segmental hepatectomy in patients with primary liver cancer.Methods 43 patients with primary liver cancer treated in Hunan Provincial People′s Hospital from January 2015 to October 2017 were retrospectively selected as the control group,and 43 patients with primary liver cancer treated from November 2017 to December 2019 were selected as the observation group.The control group was treated with irregular hepatectomy,and the observation group was treated with anatomical segmental hepatectomy under real-time ultrasound navigation.The operation,postoperative complication rate and quality of life score were compared between the two groups after different treatment.Results The portal occlusion rate and blood transfusion rate of the observation group(13.9%,9.3%)were significantly lower than those of the control group(30.2%,25.5%;all P<0.05);the operation time of the observation group[(153.4±14.20)min]was significantly longer than that of the control group[(127.3±12.10)min,P<0.05];one year after operation,the recurrence rate of the observation group(9.3%)was significantly lower than that of the control group(30.2%,P<0.05),and the survival rate(81.4%)was significantly higher than that of the control group(51.2%,P<0.05).Conclusions The application of real-time ultrasound-guided anatomical segmental hepatectomy in patients with primary liver cancer can significantly reduce the porta hepatis block rate and blood transfusion rate.It is of positive and important significance to promote the recovery of postoperative liver function,improve the quality of life and reduce the probability of disease recurrence.

关 键 词：癌 肝细胞 解剖性肝段切除 超声导航 

分 类 号：R735.7[医药卫生—肿瘤]