腹腔镜肝肿瘤切除术疗效研究

The clinical efficacy of laparoscopic liver resection with open liver resection for treatment of hepatocellular carcinoma

摘要:

目的 探讨比较腹腔镜肝切除术和开腹肝切除术治疗肝肿瘤的临床疗效。方法 回顾性分析2012年1月~2013年12月该院收治的60例肝癌患者的临床资料。依据手术治疗方案和1∶2配对研究方法将所有患者分为腹腔镜组20例（A组）和开腹组40例（B组）。A组：13例行非规则性肝切除术，7例行规则性肝左外叶切除术，无中转手助式腹腔镜或开腹手术。B组：患者中，29例行非规则性肝切除术，11例行规则性肝切除术。对两组患者的术中平均出血量、术后平均禁食时间、术后平均腹腔引流时间、术后平均住院时间、围手术期肝功能和凝血功能等指标进行统计学分析。结果 各项指标进行比较得出，A组的患者的术中平均出血量（246.12±234.35）mL明显少于B组（407.08±190.14）mL，差异有显著性（P <0.05）；A组的患者术后平均禁食时间（1.81±0.53）d、术后平均腹腔引流时间（3.11±1.36）d和术后平均住院时间（8.81±2.44）d明显短于B组，差异有显著性（P <0.05）。两组患者的ALT和AST的数值比较得出，A组患者肝功能恢复明显高于B组，差异有显著性（P <0.05）。两组患者凝血功能进行比较，差异无显著性（P >0.05）。结论 腹腔镜肝切除术治疗肝癌效果相对安全有效，有助于肝癌患者身体健康的恢复，能够提高肝癌患者的生活质量，值得在临床推广。

Abstract:

【Objective】 To investigate the clinical efficacy of laparoscopic liver resection and open liver resection in treatment of hepatocellular carcinoma. 【Methods】 Sixty cases of liver cancer patients in our hospital from January 2012 to December 2013 were retrospectively analyzed. All the patients were divided into 2 groups: laparoscopic group (Group A, 20 cases) and laparotomy group (Group B, 40 cases). Thirteen cases in the Group A were done irregular liver resection, and 7 cases in the Group A were done the rules of hepatic left lateral lobectomy without the hands-assisted laparoscopic or open surgery. Twenty-nine cases in the Group B were done irregular liver resection, and 11 cases in the Group B were done the rules of hepatic left lateral lobectomy. The average intraoperative blood loss, the mean postoperative fasting time, mean postoperative peritoneal drainage time, mean postoperative hospital stay, perioperative liver function and coagulation function in two groups of patients were analyzed statistically. 【Results】 The mean amount of bleeding in patients in group A (246.12±234.35)mL was significantly less than group B (407.08±190.14)mL. The difference was statistically significant between the two groups (P <0.05). The mean fasting time (1.81±0.53)d, mean postoperative peritoneal drainage time (3.11±1.36)d and the mean postoperative hospital stay (8.81±2.44)d in group A was significantly shorter in group B. The difference was statistically significant between the two groups (P <0.05). Liver function of patients in group A was significantly higher than group B. The difference was statistically significant between the two groups (P <0.05). Two groups of patients were compared of coagulation. The difference was not statistically significant (P >0.05). 【Conclusion】 Laparoscopic liver resection for hepatocellular carcinoma is relatively safe and effective to help restore the health of patients with hepatocellular carcinoma. It should improve the quality of patients'life with liver cancer and be worthy of promotion.