摘要
目的探讨精准肝切除技术在原发性肝癌切除中的应用价值。方法回顾性分析我院2011年1月至2012年6月收治的75例原发性肝癌行肝切除患者的临床资料,其中精准肝切除42例(精准组),非规则性肝切除33例(常规组),比较两组术后和围手术期情况,包括术中失血量和输血量,术后谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBil)水平,术后恢复时间,并发症发生率,术后肿瘤标本切缘阳性率,术后1年复发率和生存率。结果两组患者均无围手术期死亡。精准组和常规组术中失血量分别为(612±435)ml和(1325±557)ml,两组比较差异有统计学意义(t=2.578,P<0.05);术中输血量分别为(325±157)ml和(856±375)ml,两组比较差异有统计学意义(t=2.25,P<0.05);术后第3天:ALT分别为(385±296)U/L和(442±403)U/L,两组比较差异无统计学意义(t=1.132,P>0.05),AST分别为(132±115)U/L和(306±352)U/L,两组比较差异有统计学意义(t=2.41,P<0.05),TBil分别为(28±12)mmol/L和(32±18)mmol/L,两组比较差异无统计学意义(t=0.233,P>0.05);术后恢复时间分别为(9.3±3.5)d和(14.2±5.4)d,两组比较差异有统计学意义(t=2.15,P<0.05)。肿瘤标本切缘阳性率分别为7.1%(3/42)和21.2%(7/33),两组间差异有统计学意义(P<0.05);术后并发症发生率分别为9.5%(4/42)和27.3%(9/33),两组比较差异有统计学意义(P<0.05);术后1年肿瘤复发率分别为28.6%(12/42)和42.4%(14/33),术后1年生存率分别为88.1%(37/42)和78.8%(26/33),两组预后比较差异无统计学意义(P>0.05)。结论肝癌患者在准确的术前评估后采用精准肝切除,手术创伤小,术中出血少,术后恢复快,具有较好的疗效。
Objective To investigate the value of precise hepatectomy in treatment of primary liver cancer. Methods The clinical data of 75 consecutive patients with primary liver cancer who received hepatectomy at otlr hospital from January 2011 to June 2012 were retrospectively analyzed. Precise hepatectomy was applied to 42 patients （precise group） , wheareas irregular hepatectomy was applied to the rest 33 patients（ irregular group）. Compared the perioperative conditions of the two groups, including the mean bleeding volume and blood transfusion of intraoperative, the levels of serum glutamic pyruvic transaminase（ ALT）, glutamic oxalacetic transaminase（AST） and total bilirubin （TBil） in the postoperation, recovery time of postoperation, the incidence of postoperative complications, positive rate of resection margin, the tumor recurrence rate and survival rate of 1-year. Results No perioperative mortality was observed in the two groups. Mean blood loss was （612±435 ）ml in precise hepatectomy group and （1325 ± 557 ）ml in irregular hepatectomy group ,with significant difference between the two groups（ t = 2. 578, P 〈 0.05 ）. Intraoporative blood transfusion volume, postoperative level of AST, recovery time of postoperation,positive rate of resection margin and incidence of postoperative complications were （325±157） ml, （ 132±115 ） U/L, （9. 3 ± 3.5 ） d,7. 1% （3/42） and 9. 5% （4/42） in precise hepatectomy group, and were （ 856 ± 375 ） ml, （306 ± 352 ）U/L, （14. 2 ± 5.4 ）d ,21.2% （7/33 ）and 27. 3% （9/33） in irregular hepatectomy group, with significant difference between the two groups （ t = 2. 25,2. 41,2. 15, P 〈 0. 05 ）. The 1 -year tumor recurrence rate and 1-year survival rate were 28. 6% （ 12/42 ） and 88. 1% （37/42） in precise hepatectomy group,42.4% （ 14/33）and 78. 8% （26/33） in irregular hepatectomy group,with no sig- nificant difference between the two groups （ P 〉 0. 05 ）. Conclusion Precise hepatectomy is safe and effective in the treatment of liver cancer without much injury and bleeding to patients.
出处
《肝胆外科杂志》
2014年第3期178-181,共4页
Journal of Hepatobiliary Surgery
关键词
精准肝切除
原发性肝癌
precise hepatectomy
primary liver cancer
