摘要
目的探讨开腹和腹腔镜肝切除术对边缘性肝段恶性肿瘤疗效及安全性的影响。方法纳入信阳市中心医院2016年1月至2020年3月收治边缘性肝段恶性肿瘤患者共96例,其中52例采用开腹肝切除术治疗设为对照组,44例采用腹腔镜肝切除术治疗设为观察组;比较两组围手术期临床指标、手术前后肝功能指标及随访生存情况。结果观察组手术时间长于对照组(P<0.05);观察组术中出血量、术后首次下地活动时间、术后住院时间及治疗费用均少于对照组(P<0.05);观察组术后谷丙转氨酶(ALT)、谷草转氨酶(AST)及总胆红素(TBil)水平均低于术前及对照组(P<0.05);两组术后1年总生存率比较差异无统计学意义(P>0.05)。结论开腹和腹腔镜肝切除术对边缘性肝段恶性肿瘤疗效及安全性获益接近;同时腹腔镜肝切除术应用在减轻医源性损伤、加快术后康复进程、减轻经济负担及保护肝功能方面具有优势。
【Objective】To investigate the influence of open and laparoscopic hepatectomy on clinical efficacy and safety of marginal malignant hepatic tumors.【Methods】Clinical data of 96 patients with marginal malignant hepatic tumors were retrospectively chosen in the period from January 2016 to March 2020 in our hospital.All patients were divided into 2 groups including 52 cases treated with open hepatectomy as control group and 44 cases treated with laparoscopic hepatectomy as observation group.The operation time,intraoperative hemorrhage,the first time of getting out of bed after operation,postoperative hospitalization time,treatment cost,postoperative complications,liver function indexes before and after operation and survival time with follow-up of 2 groups were compared.【Results】The operation time of observation group was longer than control group(P<0.05).The intraoperative hemorrhage,the first time of getting out of bed after operation,postoperative hospitalization time and treatment cost of observation group was less than control group(P<0.05).The levels of ALT,AST and TBIL after operation of observation group were significantly less than control group and before operation(P<0.05).There was no significant difference in the 1-year overall survival rate after operation between 2 groups(P>0.05).【Conclusion】Open and laparoscopic hepatectomy in the treatment of marginal malignant hepatic tumors possess the same clinical effects and safety benefits;but laparoscopic hepatectomy application can efficiently decrease iatrogenic injury degree,speed up postoperative rehabilitation,reduce economic burden and be helpful to protect liver function.
作者
李正杰
LI Zhengjie(Department of General Surgery,Xinyang Central Hospital,Xinyang,Henan 464000,China)
出处
《中国医学工程》
2023年第3期96-100,共5页
China Medical Engineering
关键词
开腹
腹腔镜
手术
生存
安全性
open
laparoscopy
operation
survival
safety
