摘要
目的：比较肝血管瘤的介入栓塞和手术切除的治疗效果，深入对肝血管瘤治疗的认识，制定更加合理的治疗对策。方法：回顾性分析2006年1月-2011年12月首都医科大学宣武医院外科住院治疗的肝血管瘤患者的治疗特点，包括治疗指征、时机、方法、手术时间、出血量、并发症、预后、住院花费、住院时间等指标，并综合最新文献分析总结。结果：共纳入患者36例，男女比例1：5．17。年龄29～60岁，平均年龄4894-6．6岁。76．5％患者有临床症状。病灶最大径6．5～27cm。介入栓塞治疗3例，其中1例联合介入栓塞和手术切除治疗。腹腔镜手术11例（32.4％）；开腹手术24例，其中1例为腹腔镜中转开腹。术式包括右肝段切除、左肝外叶切除、左半肝切除、肝脏不规则部分切除或血管瘤摘除术。患者均治愈出院，无手术切口部位感染。1例患者出现明显血红蛋白尿和肾功能损害。随诊7～68个月，4例复发。与手术切除治疗比较，介入栓塞治疗住院时间短，住院花费无明显差异；与开腹手术比较，腹腔镜手术住院花费少，住院时间短。11例手术患者应用了射频技术，住院费用增加，但出血得到较好控制。结论：血管瘤的治疗策略应当根据治疗效果、成本效益和安全性，进行合理的个体化选择。
Objective： To study the treatment for hepatic hemangioma by superselective arte- rial embolization and partial hepatectomy to deepen the understanding of the disease and make more reasonable treatment strategy. Methods： Retrospectively study the characteristics of patients with the hepatic hemangioma enrolled in Xuanwu hospital for last 6 years, including the methods, opportunity, time of operation, bleeding, complication, prognosis, hospital stay and cost. Summarize and analysis the data with latest articles. Results： 36 cases were enrolled, the ratio of male to female is 1：5.17,age 48.9 ± 6.6 years old, 76,5% had clinical symptoms and size of hepatic hemangioma was6.5-27cm, 3 patients had arterial embolization, 11 patients had laparoscopic partial hepatectomy, 24 patients had underwent open operation. Surgery methods included right hepatic segmental resection, left lateral Iobectomy, left liver resection, irregular partial resection, and tumor extirpation. All patients were cured with no incisional infection. 1 patient had hemoglobinuria and renal dysfunction. 4 patients had relapse with follow up of 7-68 months, the hospital stay of Embolization was short and hospital cost was not different with hepatectomy. In patients with laparoscopic, Hospital costs less and the hospital stay short. 11 patients used radiofrequency which raised the cost but had a better control of the bleeding. Conclusion：Reasonable individualized treatment should be used on hepatic hemangioma with the concerns of the treatment effects, costs, and safety.
出处
《中国现代普通外科进展》
CAS
2013年第1期23-26,共4页
Chinese Journal of Current Advances in General Surgery
关键词
肝血管瘤
动脉介入治疗
部分肝切除术
Liver hemangioma·Arterial embolization·Partial hepatectomy
