腹腔镜下不同术式治疗肝囊型包虫病的临床疗效分析  

Clinical analysis of different laparoscopic procedures in the treatment of hepatic cystic echinococcosis in Tibet

作　　者：索郎多杰 高红桥[2] 巴桑顿珠[1] 仁桑[1] Duojie Suolang;Hongqiao Gao;Dunzhu Basang;Sang Ren(Tibet Autonomous Region People’s Hospital,Lhasa Tibet Autonomous Region 850000,China;Peking University First Hospital,Beijing 100035,China)

机构地区：[1]西藏自治区人民医院,拉萨850000 [2]北京大学第一医院,北京100035

出　　处：《中华普外科手术学杂志（电子版）》2023年第6期670-673,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：西藏自治区自然科学组团式援藏医学项目[XZ2021ZR-ZY11(Z)]。

摘　　要：目的比较腹腔镜下外囊完整剥离术和肝部分切除术治疗西藏地区肝囊型包虫病(HCE)的临床疗效。方法前瞻性选取2018年01月至2022年12月60例接受腹腔镜治疗的HCE患者作为研究对象,采用随机数字表法将患者按1∶1分为观察组(在腹腔镜下行外囊完整剥离术,n=30)和对照组(在腹腔镜下行肝部分切除术,n=30)。采用SPSS 22.0进行数据统计,围手术期指标等计量资料以(x±s)表示,采用独立样本t检验;术后并发症等计数资料采用χ^(2)检验。以P<0.05表示差异有统计学意义。结果观察组患者的手术时间、术中出血量、术后排气时间、下床时间、带管时间和住院时间均较对照组显著降低(P<0.05);两组患者术后均未发生胆瘘、残腔积液、胸腔积液和术后并发症总发生率比较差异无统计学意义(P>0.05);术后随访时间截至2023年02月,两组患者术后全部治愈,均未出现复发情况。结论在严格把握手术适应证的前提下腹腔镜外囊完整剥离术是腔镜下治疗西藏地区肝囊型包虫病的首选方法。Objective To compare the clinical efficacy of laparoscopic complete excision of external cysts and partial hepatectomy in the treatment of hepatic cystic echinococcosis(HCE)in Tibet.Methods Clinical data of sixty patients with HCE who received laparoscopic treatment in January 2018-2022 December 2018 in the People’s Hospital of Tibet Autonomous Region were prospective analyzed. All patients were randomly divided into observation group and control group according to random table on the ration of 1∶1. Complete cystectomy and partial hepatectomy were performed under laparoscopy respectively in observation group and control group. Data were analyzed by the software of SPSS 22.0. The measurement data showed in(x±s),such as perioperative indictors,were analyzed by independent sample t test;counting data,such as postoperative indictors,were analyzed by χ^(2) test.Results The operation time,blood loss during operation,the time to exhaust,the time to get out of bed,time with catheter and length of hospital stay in observation group were significantly decreased compared with those in control group(P<0.05). No incision and biliary leakage occurred in both groups,and there was no significant difference in the incidence of residual effusion,pleural effusion and total postoperative complications(P>0.05). Till February 2023,all patients in both groups were cured after operation,and no recurrence occurred.Conclusion Laparoscopic complete capsulectomy is the first choice to treat hepatic cystic echinococcosis in Tibet under the premise of strictly grasping the indication of operation.

关 键 词：棘球蚴病 肝 腹腔镜 肝切除术 疗效比较研究 西藏[自治区] 

分 类 号：R657.3[医药卫生—外科学]