解剖性精准肝切除术治疗肝胆恶性肿瘤患者的效果  

Effect of Anatomical Precision Hepatectomy in the Treatment of Hepatobiliary Malignancy

作　　者：屈祥富 周智 邱晖 许浩裕 QU Xiangfu;ZHOU Zhi;QIU Hui;XU Haoyu(Zhangzhou Third Hospital,Zhangzhou 363000,China;不详)

机构地区：[1]漳州市第三医院,福建漳州363000

出　　处：《中外医学研究》2023年第7期14-18,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析解剖性精准肝切除术治疗肝胆恶性肿瘤患者的效果。方法:选取2020年1月—2021年12月漳州市第三医院收治的65例肝胆恶性肿瘤患者。根据随机数表法将其分为解剖组(33例)和精切组(32例)。精切组给予精准肝切除术,解剖组给予解剖性精准肝切除术。比较两组围手术期指标,术前及术后1 d、3 d的疼痛程度,术前及术后细胞免疫功能、肝功能指标,并发症。结果:两组术中出血量比较差异无统计学意义(P>0.05);解剖组手术时间长于精切组,术后引流时间和住院时间均短于精切组,初次进食时间、初次肛门排气时间均早于精切组,差异均有统计学意义(P<0.05)。术后1 d、3 d两组视觉模拟评分法(VAS)评分先升高后降低,且解剖组VAS评分低于精切组,差异均有统计学意义(P<0.05)。术后,解剖组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均高于精切组,CD8^(+)低于精切组,差异均有统计学意义(P<0.05)。术后,解剖组直接胆红素(DBIL)、总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)水平均低于精切组,差异均有统计学意义(P<0.05)。解剖组术后并发症发生率(6.06%)显著低于精切组(25.00%),差异有统计学意义(P<0.05)。结论:解剖性精准肝切除术能减轻肝胆恶性肿瘤患者免疫功能和肝功能损伤,加快术后恢复进程,提高安全性,但会延长手术时间。Objective:To analyze the effect of anatomical precision hepatectomy in the treatment of hepatobiliary malignancy.Method:From January 2020 to December 2021,65 patients with hepatobiliary malignancy admitted to Zhangzhou Third Hospital were selected.According to the random number table method,they were divided into anatomical group(33 cases)and precision resection group(32 cases).Precision resection group was given the precise hepatectomy,and the anatomical group was given anatomical precision hepatectomy.The perioperative indexes,the degree of pain before operation and 1 d and 3 d after operation,cellular immune function and liver function indexes before operation and after operation,and complications were compared between the two groups.Result:There was no significant difference in intraoperative blood loss volume between the two groups(P>0.05).The operation time of the anatomical group was longer than that of the precision resection group,the postoperative drainage time and hospital stay were shorter than those of the precision resection group,the first feeding time and the first anal exhaust time were earlier than those of the precision resection group,and the differences were statistically significant(P<0.05).The visual analogue scale(VAS)scores of the two groups increased first and then decreased at 1 d and 3 d after operation,and the VAS scores of the anatomical group were lower than those of the precision resection group,and the differences were statistically significant(P<0.05).After operation,CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the anatomical group were higher than those in the precision resection group,and CD8^(+)was lower than that in the precision resection group,and the differences were statistically significant(P<0.05).After operation,the levels of direct bilirubin(DBIL),total bilirubin(TBIL),glutamic-pyruvic transaminase(ALT)and glutamic-oxaloacetic transaminase(AST)in the anatomical group were lower than those in the precision resection group,and the differences were statistically significant(P<0.05)

关 键 词：精准肝切除术 解剖性 肝胆恶性肿瘤 免疫功能 肝功能 

分 类 号：R735.7[医药卫生—肿瘤] R735.8[医药卫生—临床医学]