腹腔镜手术治疗巨大肝血管瘤患者疗效研究  

Laparoscopic hepatectomy in the treatment of patients with giant hepatic hemangioma

作　　者：朱加猛 范丽琴 尹力 吴柏华 Zhu Jiameng;Fan Liqin;Yin Li(Department of General Surgery,Shuyang Hospital Affiliated to Nanjing University of Traditional Chinese Medicine,Suqian 223600,Jiangsu Province,China)

机构地区：[1]南京中医药大学附属沭阳医院普外科,江苏省宿迁市223600

出　　处：《实用肝脏病杂志》2023年第4期564-567,共4页Journal of Practical Hepatology

基　　金：江苏省宿迁市科技局指导性科研计划项目(编号:Z2020063)。

摘　　要：目的分析比较采用腹腔镜手术与开腹手术治疗巨大肝血管瘤(GHH)患者的临床效果。方法2012年6月~2022年1月我科诊治的GHH患者54例,其中30例接受腹腔镜手术,另24例接受开腹手术。常规检测血清C-反应蛋白(CRP)和降钙素原(PCT)水平。结果腔镜组肿瘤直径及肝左叶、肝右叶和左右叶肿瘤占比分别为(12.2±2.5)cm、30.0%、46.7%和23.3%,与开腹组比,无显著性差异【分别为(11.3±1.9)cm、29.2%、54.2%和16.7%,P>0.05】;腹腔镜组术中失血量为(188.3±70.5)ml,显著少于开腹组【(285.6±116.5)ml,P<0.05】,而肝门阻断时间为(26.2±10.2)min,显著长于开腹组【(15.2±9.7)min,P<0.05】;腹腔镜组腹腔引流量为(180.5±72.6)ml,显著少于开腹组【(282.3±102.8)ml,P<0.05】,术后住院日为(8.2±2.8)d,显著短于开腹组【(11.6±3.2)d,P<0.05】,血清C-反应蛋白(CRP)和降钙素原(PCT)分别为(31.8±14.4)mg/L和(0.1±0.1)ng/ml,显著低于开腹组【分别为(56.4±20.5)mg/L和(0.2±0.1)ng/ml,P<0.05】。结论采用腹腔镜手术治疗GHH患者是安全可行的,相较于开腹手术具有全身炎症反应轻和术后恢复快的优势。Objective This study was to conducted to compare the clinical efficacy of laparoscopic hepatectomy(LH)and traditional open surgery(OS)in the treatment of patients with giant hepatic hemangioma(GHH).Methods 54 patients with GHH were encountered in our hospital between June 2012 and January 2022,and were divided into two groups,receiving LH(n=30)or traditional open surgery(n=24)treatment.The clinical data before and after operation in the two groups were compared.Results The tumor diameter,the percentages of tumors in the left,right and both lobes in LH-surgery-treated patients were(12.2±2.5)cm,30.0%,46.7%and 23.3%,all not significantly different compared to[(11.3±1.9)cm,29.2%,54.2% and 16.7%,respectively,P>0.05]in open surgery-treated patients;the intra-operational blood loss in LH-treated patients was(188.3±70.5)ml,much less than[(285.6±116.5)ml,P<0.05],while the blocking time of hilus hepatis was(26.2±10.2)min,much longer than[(15.2±9.7)min,P<0.05]in open surgery-treated patients;the drainage volume in LH-treated patients was(180.5±72.6)ml,much less than[(282.3±102.8)ml,P<0.05],the post-operational hospital stay was(8.2±2.8)days,significantly shorter than[(11.6±3.2)days,P<0.05],and serum C-reactive protein and procalcitonin levels were(31.8±14.4)mg/L and(0.1±0.1)ng/ml,significantly lower than[(56.4±20.5)mg/L and(0.2±0.1)ng/ml,respectively,P<0.05]in open surgery-treated patients.Conclusion The application of LH in the treatment of patients with GHH is safe and feasible,which might be lead to mild systemic inflammatory reactions,and relatively faster recovery after operation.

关 键 词：巨大肝血管瘤 腹腔镜手术 肝门阻断时间 降钙素原 治疗 

分 类 号：R735.7[医药卫生—肿瘤]