摘要
目的：探讨腹腔镜精准肝切除与开腹常规肝切除治疗原发性肝癌的疗效。方法选取我院2013年5月～2015年5月原发性肝癌70例，按按照入院时间顺序编号，采用随机数字表随机分为对照组（n＝35）与观察组（n＝35），对照组接受开腹常规肝切除手术，观察组接受腹腔镜精准肝切除手术。比较2组患者手术情况、术后肝功能、并发症和预后等指标。结果观察组与对照组手术时间分别为（102．4±23．1）、（98．3±21．3）min，2组比较无明显差异（t＝0．772，P＝0．221）。观察组术中出血量（214．6±37．5）ml，明显少于对照组（379．3±45．1）ml（t＝-16．612，P＝0．000）。观察组住院时间（8．5±2．5） d，明显短于对照组（12．4±3．2）d（t＝-5．682，P＝0．000）。观察组术后AST（10．5±2．3）U／L，明显低于对照组（15．2±1．9） U／L（t＝-9.320，P＝0．000）；ALT（21．4±2．8）U／L，明显低于对照组（30．2±3．3） U／L（t ＝-12．030，P＝0．000）；ALB （56．4±2．4）g／L，高于对照组（42．3±2．0） g／L（t＝26．701，P＝0．000）；TBIL（17．3±1．6）μmol／L，明显高于对照组（15．6±1.1）μmol／L（t＝5．180，P＝0．000）。观察组并发症发生率5．7%（2／35），明显低于对照组22．9%（8／35，χ^2＝4．200，P＝0.040）。术后6个月观察组复发转移率3．1%（1／32），对照组转移复发率12．1%（4／33），2组患者转移复发率无明显差异（χ^2＝0．801，P＝0．371）。2组生存率log-rank检验存在显著差异（χ^2＝5．300，P＝0．021）。结论腹腔镜精准肝切除治疗原发性肝癌可行，具有创伤小、安全性高等特点，值得临床推广。
Objective To explore the efficacy of laparoscopic precise liver resection and open conventional hepatectomy for the treatment of primary hepatic carcinoma . Methods A total of 70 patients with primary hepatic carcinoma were selected in our hospital from May 2013 to May 2015.All the patients were randomly assigned to either control group （n=35） or observation group （n=35） according to a random number table .The operation condition, liver functions, postoperative complications and other indicators were compared between the two groups . Results The operation time of the observation group and the control group were （102.4 ±23.1） min and （98.3 ±21.3） min, respectively, without significant difference （t=0.772, P=0.221）.The amount of bleeding in the observation group was （214.6 ±37.5） ml, which was significantly less than that in the control group [（379.3 ±45.1） ml, t=16.612, P=0.000].The length of hospital stay in the observation group was （8.5 ±2.5） d, which was significantly shorter than that in the control group [（12.4 ±3.2） d, t=-5.682, P=0.000].The postoperative AST level in the observation group was （10.5 ±2.3） U/L, which was lower than that in the control group [（15.2 ±1.9） U/L, t=-9.320, P=0.000].The postoperative ALT level in the observation group [（21.4 ±2.8） U/L] was significantly lower than that in the control group [（30.2 ±3.3） U/L, t=-12.030, P=0.000].The postoperative ALB level in the observation group [（56.4 ±2.4） g/L] was significantly higher than that in the control group [（42.3 ±2.0） g/L, t=26.701, P=0.000].The postoperative TBIL level in the observation group was （17.3 ±1.6） μmol/L, which was significantly higher than that in the control group [（15.6 ±1.1） μmol/L, t=5.180, P=0.000]. The complication rate of the observation group was 5.7%（2/35）, significantly lower than that of the control group [22.9%（8/35）,χ^2 =4.200, P=0.040）.After 6 months after the surgery, the recurrence rate was 3.1%（1/32） in the observation group and was 12.1%（4/33） in the control group, and there was no significant difference in the recurrence rate between the two groups （χ^2 =0.801,P=0.371）.The survival rate of the observation group was significantly higher than that of the control group （log-rank χ^2 =5.300, P=0.021）. Conclusion Laparoscopic precise hepatectomy for primary liver cancer has high feasibility , low trauma, and high safety, being worthy of clinical application .
出处
《中国微创外科杂志》
CSCD
北大核心
2016年第7期590-593,共4页
Chinese Journal of Minimally Invasive Surgery
关键词
腹腔镜
精准肝切除
原发性肝癌
Laparoscope
Precise hepatectomy
Primary hepatic carcinoma
