区域性入肝血流阻断对腹腔镜肝切除术治疗原发性肝癌的近期疗效及安全性评价  

Short-term efficacy and safety evaluation of regional hepatic flow blockade in laparoscopic hepatectomy for primary liver cancer

作　　者：古丽斯坦[1] 康书红 谷申森 GULISTAN;KANG Shu-hong;GU Shen-sen(Department of Liver Laparoscopic Surgery,The First Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang 830054,China;Department of Gastrointestinal Surgical Oncology,The First Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang 830054,China)

机构地区：[1]新疆医科大学第一附属医院肝脏腹腔镜外科,新疆乌鲁木齐830054 [2]新疆医科大学第一附属医院胃肠肿瘤外科,新疆乌鲁木齐830054

出　　处：《临床和实验医学杂志》2025年第1期14-18,共5页Journal of Clinical and Experimental Medicine

基　　金：新疆维吾尔自治区自然科学基金资助项目(编号:2021D01C304)。

摘　　要：目的 研究区域性入肝血流阻断对腹腔镜肝切除术治疗原发性肝癌的近期疗效及安全性。方法 回顾性选取2022年7月至2023年7月新疆医科大学第一附属医院收治的120例原发性肝癌患者为研究对象,根据血流阻断技术不同分为观察组(n=60)和对照组(n=60)。观察组患者给予区域性入肝血流阻断治疗,对照组患者给予间歇性全入肝血流阻断。分析并比较两组患者的手术指标(手术时间、术中出血量、术后首次排气时间及住院时间)、近期疗效,术前、术后3 d的肝功能[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBil)、白蛋白],术前、术后7 d的营养指标(白蛋白、血红蛋白、前白蛋白、转铁蛋白)及并发症发生情况。结果 两组的手术时间比较,差异无统计学意义(P>0.05),观察组的术中出血量为(301.27±52.45) mL,低于对照组[(368.11±58.73) mL],术后首次排气时间及住院时间分别为(2.54±0.71)、(7.25±1.49) d,均短于对照组[(3.14±0.68)、(8.51±1.22) d],差异均有统计学意义(P<0.05)。观察组患者的总有效率为95.00%,显著高于对照组(75.00%),差异有统计学意义(P<0.05)。术后3 d,两组患者的ALT、AST、TBil水平均较术前明显升高,白蛋白水平较术前明显降低,差异均有统计学意义(P<0.05);但观察组术后3 d的ALT、AST、TBil水平分别为(65.56±13.85) U/L、(53.76±5.62) U/L、(25.76±5.62)μmol/L,均明显低于对照组[(71.17±9.34) U/L、(62.39±4.51) U/L、(29.39±6.51)μmol/L],白蛋白水平为(35.36±5.22) g/L,明显高于对照组[(31.11±4.47) g/L],差异均有统计学意义(P<0.05)。术后7 d,两组患者的血清白蛋白、血红蛋白、前白蛋白、转铁蛋白水平均较术前明显升高,且观察组术后7 d的血清白蛋白、血红蛋白、前白蛋白、转铁蛋白水平分别为(55.26±6.33) g/L、(120.35±10.39) g/L、(236.98±15.69) mg/L、(1.78±0.53) g/L,均明显高于对照组[(50.18±4.26) g/L、(114.06±9.35) g/L、Objective To analyze the effect of regional hepatic blood flow blockade in laparoscopic hepatectomy for primary liver cancer.Methods A total of 120 patients with primary liver cancer admitted to The First Affiliated Hospital of Xinjiang Medical University from July 2022 to July 2023 were retrospectively selected as the research objects.According to different blood flow occlusion techniques,they were divided into the observation group(n=60)and the control group(n=60).The patients in the observation group were treated with regional hepatic blood flow occlusion,and the patients in the control group were treated with intermittent total hepatic blood flow occlusion.The operation indexes(operation time,intraoperative blood loss,first postoperative exhaust time and hospitalization time),short-term efficacy,liver function[alanine transaminase(ALT),aspartate transaminase(AST),total bilirubin(TBil),albumin]before operation and 3 days after operation,nutritional indexes(albumin,hemoglobin,prealbumin,transferrin)before operation and 7 days after operation and complications were analyzed and compared between the two groups.Results There was no statistically significant difference in the operation time between the two groups(P>0.05).The intraoperative blood loss in the observation group was(301.27±52.45)mL,which was lower than that in the control group[(368.11±58.73)mL],the first postoperative exhaust time and hospitalization time were(2.54±0.71)and(7.25±1.49)d,respectively,which were shorter than those in the control group[(3.14±0.68)and(8.51±1.22)d],and the differences were statistically significant(P<0.05).The total effective rate of the observation group was 95.00%,which was significantly higher than that of the control group(75.00%),and the difference was statistically significant(P<0.05).Three days after operation,the levels of ALT,AST and TBil in the two groups were significantly higher than those before operation,and the level of albumin was significantly lower than that before operation,the differences were stat

关 键 词：肝肿瘤 腹腔镜 肝切除术 区域性入肝血流阻断 近期疗效 安全性 

分 类 号：R73[医药卫生—肿瘤]