肝细胞癌精准肝切除在基层医院的应用研究  

Application of Precise Hepatectomy for Hepatocellular Carcinoma in Primary Hospitals

作　　者：邓少伟 赖彦华 周厚富 DENG Shao-wei;LAI Yan-hua;ZHOU Hou-fu(Department of General Surgery,the People’s Hospital of Zhongshan County,Zhongshan 542699,Guangxi,China;Department of Transplantation,the People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi,China)

机构地区：[1]钟山县人民医院普通外科,广西钟山542699 [2]广西壮族自治区人民医院移植科,广西南宁530021

出　　处：《医学信息》2024年第12期98-101,106,共5页Journal of Medical Information

摘　　要：目的探讨基层医院开展精准肝切除治疗肝细胞癌的可行性。方法回顾性分析2010年1月-2017年12月钟山县人民医院完成的188例行开放性肝切除的肝细胞癌患者资料,根据手术方式分为精准肝切除术组和常规肝切除术组,术后随访5年,比较两组手术耗时、术中出血量、术中输血量、住院时间、术后第3天转氨酶和总胆红素、并发症及生存率。结果纳入精准肝切除术组95例,常规肝切除术组93例。两组手术时间、术中输血例数以及并发症比较,差异无统计学意义(P>0.05);精准肝切除术组术中出血量,住院时间,术后第3天血清谷丙转氨酶、谷草转氨酶和总胆红素低于常规肝切除术组(P<0.05);两组术后1、3、5年总体生存率比较,差异无统计学意义(P>0.05);精准肝切除术组后1、3、5年无瘤生存率高于常规肝切除术组(P<0.05)。结论精准肝切除术比常规肝切除术根治肝细胞癌具有手术创伤小、术后肝功能恢复快、无瘤生存率高等明显优势,值得在基层医院应用。Objective To explore the feasibility of precise hepatectomy in the treatment of hepatocellular carcinoma in primary hospitals.Methods The clinical data of 188 patients with hepatocellular carcinoma who underwent open hepatectomy in the People’s Hospital of Zhongshan County from January 2010 to December 2017 were retrospectively analyzed.According to the surgical methods,the patients were divided into precise hepatectomy group and conventional hepatectomy group.The patients were followed up for 5 years.The operation time,intraoperative blood loss,intraoperative blood transfusion,hospitalization time,transaminase and total bilirubin on the 3rd day after operation,complications and survival rate were compared between the two groups.Results There were 95 cases in the precise hepatectomy group and 93 cases in the conventional hepatectomy group.There was no significant difference in operation time,the number of intraoperative blood transfusion cases and complications between the two groups(P>0.05).The intraoperative blood loss,hospitalization time,serum alanine aminotransferase,aspartate aminotransferase and total bilirubin on the 3rd day after operation in the precise hepatectomy group were lower than those in the conventional hepatectomy group(P<0.05).There was no significant difference in the 1-,3-,and 5-year overall survival rates between the two groups(P>0.05).The 1-,3-and 5-year free survival rates in the precise hepatectomy group were higher than those in the conventional hepatectomy group(P<0.05).Conclusion Compared with conventional hepatectomy,precise hepatectomy has the obvious advantages of less surgical trauma,faster postoperative liver function recovery and higher free survival rate,which is worthy of application in primary hospitals.

关 键 词：精准肝切除 肝细胞癌 常规肝切除 

分 类 号：R9735.7[医药卫生—药品]