腹腔镜下解剖性肝切除术对原发性肝癌患者手术指标、无瘤生存率及肝功能的影响  

The effects of anatomical laparoscopic hepatolobectomy on surgical indicators,tumor-free survival rate and liver function in patients with primary liver cancer

作　　者：李俊[1] 王学文[1] 罗国松 LI Jun;WANG Xue-wen;LUO Guo-song(Department of Hepatobiliary Surgery,Zigong Fourth People′s Hospital,Zigong 643000,China)

机构地区：[1]四川省自贡市第四人民医院肝胆外科,四川自贡643000

出　　处：《实用医院临床杂志》2022年第6期85-88,共4页Practical Journal of Clinical Medicine

摘　　要：目的 探讨腹腔镜下解剖性肝切除术(ALH)对原发性肝癌患者的效果。方法 自贡市第四人民医院收治的110例原发性肝癌患者,按照随机数字表分为非ALH(NALH)组和ALH组各55例,NALH组行NALH手术,ALH组行ALH。两组患者均门诊随访1年,并比较手术指标、肝功能、无瘤生存率及复发率、并发症发生情况。结果 与NALH组比较,ALH组术中出血量、输血量、住院时间以及1年总复发率均降低,术后6个月、1年无瘤生存率较高(P<0.05);两组术后血清总胆红素(TBIL)与丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)水平均升高,NALH组指标高于ALH组(P<0.05)。结论 ALH可有效改善原发性肝癌患者手术指标,提升无瘤生存率,降低复发率,极大保护肝脏,安全性较高。Objective To explore the effects of anatomical laparoscopic hepatolobectomy(ALH) in patients with primary liver cancer.Methods One hundred and ten patients with primary liver cancer in our hospital were enrolled. The patients were divided into a non anatomical laparoscopic hepatolobectomy(NALH) group and an ALH group, 55 in each group. The NALH group underwent non-ALH treatment, and the ALH group underwent ALH. Both groups of patients were followed up in outpatient clinic for 1 year. Surgical indicators, liver function, tumor-free survival rate, recurrence rate and complications were compared between the two groups. Results Compared with the NALH group, the ALH group had lower intraoperative blood loss, less blood transfusion volume, shorter hospital stay and lower 1-year total recurrence rate, and higher tumor-free survival rate after 6 months and 1 year of operation(P<0.05). The levels of serum total bilirubin(TBIL), alanine aminotransferase(ALT) and aspartate aminotransferase(AST) in both groups were increased, and the indexes in the NALH group were higher than those in the ALH group(P<0.05).Conclusions ALH can effectively improve the surgical indicators of patients with primary liver cancer, improve the tumor-free survival rate and reduce the recurrence rate, and greatly protect the liver. It also has high safety.

关 键 词：腹腔镜下解剖性肝切除术 原发性肝癌 手术指标 无瘤生存率 肝功能 

分 类 号：R735.7[医药卫生—肿瘤]