腹腔镜肝切除术与肝动脉介入栓塞术治疗肝血管瘤的有效性和安全性分析  

Analysis of the Effectiveness and Safety of Laparoscopic Liver Resection and Hepatic Artery Embolization for the Treatment of Hepatic Heman⁃gioma

作　　者：杨军军 赵鑫 邓斗兴 YANG Junjun;ZHAO Xin;DENG Douxing(Department of Hepatobiliary Surgery,Shanghai First People's Hospital Jiuquan Hospital(Jiuquan People's Hospital),Jiuquan 735000,Gansu,China)

机构地区：[1]上海市第一人民医院酒泉医院(酒泉市人民医院)肝胆外科,甘肃酒泉735000

出　　处：《系统医学》2024年第24期146-150,共5页Systems Medicine

摘　　要：目的 对比分析腹腔镜肝切除术与肝动脉介入栓塞术对肝血管瘤的疗效。方法 回顾性选取2022年1月—2023年12月在上海市第一人民医院酒泉医院就诊的96例肝血管瘤患者的临床资料,根据治疗方案的不同分为腹腔镜组(行腹腔镜肝切除术)与介入组(行肝动脉介入栓塞术),每组各48例。比较两组手术情况、疗效、肝功能指标、肿瘤标志物水平及并发症。结果 腹腔镜组手术时间、术中出血量、住院时间均高于介入组,差异有统计学意义(P均<0.05)。腹腔镜组总有效率与介入组比较,差异无统计学意义(P>0.05)。术后,两组血清谷丙转氨酶、谷草转氨酶、碱性磷酸酶较术前均升高,且腹腔镜组均高于介入组,差异有统计学意义(P均<0.05)。术后,两组甲胎蛋白、癌胚抗原水平较术前均下降,且腹腔镜组(22.14±1.71)μg/L、(4.56±0.87)ng/mL低于介入组(25.31±2.06)μg/L、(5.83±1.13)ng/mL,差异有统计学意义(t=8.203、6.170,P均<0.05)。腹腔镜组术后并发症总发生率与介入组比较,差异无统计学意义(P>0.05)。结论 与肝动脉介入栓塞术相比,腹腔镜肝切除术的手术时间更长、出血量更多、恢复速度更慢,且对肝功能的损伤程度更大,但可促进相关肿瘤标志物水平下降,二者近期疗效无显著差异,且术后并发症发生风险较为相近。Objective To compare and analyze the therapeutic effects of laparoscopic liver resection and hepatic ar‐tery embolization on hepatic hemangioma.Methods A retrospective selection was conducted on the clinical data of ninety-six patients with hepatic hemangioma who admitted in Shanghai First People's Hospital Jiuquan Hospital from January 2022 to December 2023.According to the different treatment plans,they were divided into a laparoscopic group(laparoscopic liver resection)and an intervention group(hepatic artery embolization),with forty-eight cases in each group.Compare the surgical outcomes,therapeutic effects,liver function indicators,tumor marker levels,and postoperative complications between two groups.Results The laparoscopic group had higher surgical time,intraopera‐tive blood loss,and hospitalization time than the intervention group,the differences were statistically significant(all P<0.05).There was no statistically significant difference in total effective rate between two groups(P>0.05).After sur‐gery,the levels of serum alanine aminotransferase,aspartate aminotransferase,and alkaline phosphatase in both groups increased compared with those before surgery,and the levels in the laparoscopic group were all higher than those in the intervention group,and the differences were statistically significant(all P<0.05).After surgery,the levels of alpha-fetoprotein and carcinoembryonic antigen in both groups decreased compared with those before surgery,and the levels in the laparoscopic group were(22.14±1.71)μg/L for alpha-fetoprotein and(4.56±0.87)ng/mL for carcino‐embryonic antigen,which were lower than(25.31±2.06)μg/L and(5.83±1.13)ng/mL in the intervention group,and differences were statistically significant(t=8.203,6.170,both P<0.05).There was no statistically significant difference in total incidence of postoperative complications between the two groups(P>0.05).Conclusion Compared with hepatic artery embolization,laparoscopic liver resection has a longer surgical time,more bleeding,slower recov

关 键 词：肝血管瘤 腹腔镜肝切除术 肝动脉介入栓塞术 肝功能 肿瘤标志物 并发症 

分 类 号：R4[医药卫生—临床医学]