解剖性肝切除术治疗肝癌合并微血管侵犯的价值  

Value of Anatomical Liver Resection in the Treatment of Liver Cancer Complicated with Microvascular Invasion

作　　者：曹玉明[1] CAO Yuming(Department of Surgery,Jinan Tianqiao People's Hospital,Jinan 250031,China)

机构地区：[1]济南市天桥人民医院外科,山东济南250031

出　　处：《中国医学创新》2025年第12期73-76,共4页Medical Innovation of China

摘　　要：目的:研究解剖性肝切除术(AR)治疗肝癌合并微血管侵犯(MVI)患者的临床价值。方法:回顾性分析2019年2月—2022年1月济南市天桥人民医院收治的97例肝癌合并MVI患者的临床资料,根据手术方法不同分为观察组(接受AR,n=54)和对照组[接受非解剖性肝切除术(NAR),n=43]。比较两组手术和肿瘤相关指标,随访记录两组术后生存率。结果:观察组手术时间长于对照组,术中出血量少于对照组,术中输血率低于对照组,术后拔管时间和术后住院时间均短于对照组(P<0.05)。观察组术后并发症发生率低于对照组(P<0.05)。观察组术后3年无瘤生存率高于对照组(P<0.05);两组术后3年总生存率比较,差异无统计学意义(P>0.05)。结论:AR治疗肝癌合并MVI患者术中出血量更少,术中输血率更低,可缩短住院时间,安全性更好,且可获得更好的无瘤生存率。Objective:To investigate the clinical value of anatomical liver resection(AR)in the treatment of liver cancer complicated with microvascular invasion(MVI).Method:The clinical data of 97 patients with liver cancer complicated with MVI admitted to Jinan Tianqiao People's Hospital from February 2019 to January 2022 were retrospectively analyzed.According to different surgical methods,they were divided into observation group(receiving AR,n=54)and control group[receiving non-anatomical liver resection(NAR),n=43].Surgery and tumor related indexes were compared between the two groups,and postoperative survival rates were recorded during follow-up.Result:The operation time of the observation group was longer than that of the control group,the amount of blood loss during operation was less than that of the control group,the rate of blood transfusion during operation was lower than that of the control group,the postoperative extubation time and postoperative hospitalization time were shorter than those of the control group(P<0.05).The incidence of postoperative complications in observation group was lower than that in control group(P<0.05).The 3-year none tumor survival rate of observation group was higher than that of control group(P<0.05).There was no significant difference in the 3-year overall survival rate between the two groups(P>0.05).Conclusion:AR treatment of patients with liver cancer complicated with MVI has less intraoperative blood loss,lower intraoperative blood transfusion rate,and can shorten hospital stay,with better safety and better tumor-free survival.

关 键 词：解剖性肝切除术 非解剖性肝切除术 肝癌 微血管侵犯 

分 类 号：R735.7[医药卫生—肿瘤]