摘要
目的探讨美蓝染色标记法联合Glisson蒂横断式肝切除与非规则性肝切除治疗肝癌的临床疗效。方法对美蓝染色标记法联合Glisson蒂横断式肝切除25例(联合组)与非规则性肝切除23例(非规则组)治疗肝癌作前瞻性研究,比较两组患者围手术期情况,包括平均手术时间、术中出血量、术后1 d和4 d AST的水平、肿瘤标本切缘阳性率、并发症发生率、术后1年复发率和1年生存率等,并分析其临床疗效。结果两组患者均无围手术期死亡病例。联合组平均手术时间较非规则组少[(120.16±15.45)min vs(130.26±8.48)min,t=2.77,P<0.05];联合组术中出血量较非规则组少[(252.40±81.25)ml vs(493.44±100.96)ml,t=8.42,P<0.05];联合组术后1 d、4 d AST水平上升幅度较非规则组小[(1 d AST:(143.76±49.48)U/L vs(253.82±77.79)U/L,t=5.90,P<0.05;4 d AST:(79.36±24.51)U/L vs(129.57±45.66)U/L,t=4.80,P<0.05];肿瘤标本切缘阳性率分别为4.0%和8.7%(P>0.05);围手术期并发症发生率联合组较非规则组低(12.00%vs 39.13%,P<0.05);术后1年复发率联合组较非规则组低(20.00%vs 47.83%,P<0.05);术后1年生存率两组差异无统计学意义(80.00%vs78.26%,P>0.05)。结论美蓝染色标记法联合Glisson蒂横断式肝切除较非规则性肝切除治疗肝癌的术中出血量和术后并发症少,患者术后恢复快,复发率低,值得临床推广应用。
Objective To investigate the clinical efficacy of methylene blue staining notation and Glissonean pedicle transection for treating hepatocellular carcinoma. Methods A total of 25 patients underwent methylene blue staining notation and Glissonean pedicle transection （combined group）, and 23 patients underwent irregular hver resection （irregular group）. The two groups were compared in termsof mean operating time,blood loss,AST levels at 1 and 4 days after surgery, 1-year survival and recurrence rates. Results No mortality was observed in either group. Compared to the irregular group, the combined group showed significantly shorter mean operating time [ （ 120.16± 15.45 ） min vs （ 130.26±8.48 ） min, t=2.77, P〈0.05 ], lower blood loss [ （252.40±81.25 ） ml vs （493.44± 100.96 ） ml, t=8.42 ,P〈0.05 ], and smaller increases in AST at postoperative day 1 [（ 143.76±49.48 ） U/L vs （253.82±77.79）U/L, t=5.90, P〈0.05] and postoperative day 4 [ （79.36±24.51）U/L vs （129.57±45.66） UIL,t=4.80,P〈0.05 ]. The rate of positive tumor excision was 4.0% in the combined group and 8.7% in the irregular group （P〉0.05）. The rate of perioperative complications was lower in the combined group （12.00% vs 39.13%,P〈0.05）,as was the 1-year recurrence rate （20,00% vs 47.83%,P〈0.05）. Survival rates at 1 year were similar in the two groups（80.00% vs 78.26% ,P〉0.05）. Conclusion Methylene blue staining notation combined with Glissonean pedicle transection offers several advantages over irregular resection for treating hepatoeellular carcinoma,including less intraoperative bleeding,fewer postoperative complications,lower tumor recurrence and better postoperative recovery.
出处
《中国癌症防治杂志》
CAS
2015年第2期104-108,共5页
CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT
