摘要
目的:观察围手术期腹腔镜下肝切除术患者纤维化及氧代谢指标的变化,探讨腹腔镜下肝切除治疗肝癌的优越性。方法:收集来我科进行肝切除的病例53例,随机分为对照组(开腹手术组,n=25)和研究组(腹腔镜下肝切除组,n=28)。比较两组间手术情况及术后恢复情况差异,比较围手术期两组间纤维化及氧代谢指标差异。结果:两组间手术时间、术中出血量、肿瘤切缘及切除肝脏体积比较,差异无统计学意义(P>0.05);研究组术后下床活动时间、术后第一次进食时间、住院天数短于对照组,差异具有统计学意义(P<0.05);术后3、7、14d,研究组血浆AST、ALT及CRP水平均低于对照组,差异具有统计学意义(P<0.05);研究组围手术期氧代谢指标并无明显波动,但对照组波动明显。术后1、3、7、14d,研究组纤维化相关指标HA、PCⅢ和ⅣC水平均低于对照组,差异具有统计学意义(P<0.05)。结论:腹腔镜下肝切除术治疗肝癌的疗效与开腹手术一致,但腹腔镜手术具有手术创伤小、肝脏受损程度小、术后恢复快的优点。
Objective： To observe the changes in fibrosis and oxygen metabolism index for patients during perioperative period of laparoscopic liver resection, and to explore the advantages of laparoscopic liver resection in the treatment of liver canc- er. Methods.. According to the inclusion criteria, 53 cases of patients who took liver resection in our hospital were randomly di- vided into control group （open operation group , n=25） and research group （laparoscopic liver resection group, n= 28）. Then the operation and postoperative recovery of both groups were compared, and the fibrosis and oxygen metabolism indexes of both groups during perioperative period were compared as well. Results.. There was no significant difference in operation time, bleeding volume, tumor resection margin and liver resection volume between the two groups, P〉0.05; but the postoperative activity time, postoperative eating time and length of hospital stay in research group were significantly shorter than the control group, with statistically significant differences （P〈0.05）. Postoperative 3, 7, 14 days, the serum levels of AST, AI.T and CRP were significantly lower in research group than the control group, with statistically significant differences （P〈0.05）. During perioperative period, there was no obvious fluctuation in the oxygen metabolism index in research group, while signifi- cantly obvious fluctuation was observed in the control group. Postoperative 1, 3, 7, 14 days, the levels of fibrosis index such as HA,PCm and 1VC of research group were significantly lower than control group, with statistically significant differences （P〈 0.05）. Conclusions：The efficacy of laparoscopic hepatectomy for liver cancer is consistent with the open operation, however, laparoscopic surgery has the advantages of small trauma, small liver damage and rapid recovery.
出处
《海南医学院学报》
CAS
2016年第8期784-786,791,共4页
Journal of Hainan Medical University
基金
安徽省卫生厅资质基金(wh29123)~~
关键词
肝切除术
腹腔镜
纤维化
氧代谢
Liver resections Laparoscope
Fibrosis
Oxygen metabolism
