摘要
目的探讨腹腔镜左半肝切除治疗原发性肝癌中使用Glisson鞘外血流阻断法的疗效。方法选取龙岩市第二医院接收的96例行腹腔镜下左半肝切除的原发性肝癌患者,样本案例择取时间为2021年9月至2024年9月,按照手术方式分组,开展施Glisson鞘外血流阻断法的患者(n=48)为观察组,开展Pringle全入肝血流阻断法的患者(n=48)为对照组。对比两组相关治疗指标、肝脏功能、并发症。结果观察组手术时间、住院时间短于对照组,且术中出血量少于对照组(P<0.05)。术后3 d,观察组患者总胆红素、谷草转氨酶、谷丙转氨酶指标低于对照组(P<0.05);但白蛋白、凝血酶原时间指标差异无统计学意义(P>0.05)。观察组并发症总发生率低于对照组(P<0.05)。结论在腹腔镜左半肝切除治疗原发性肝癌中的应用Glisson鞘外血流阻断法与Pringle全入肝血流阻断法均可取得一定的效果,但采用Glisson鞘外血流阻断技术实施手术,其手术时长更为精简,在手术过程中出血量可得到有效控制,且术后出现并发症情况更少。
Objective To investigate the therapeutic effect of extra-Glissonian vascular inflow occlusion in laparoscopic left hemihepatectomy for primary liver cancer.Methods A total of 96 patients with primary liver cancer who underwent laparoscopic left hemihepatectomy at the Second Hospital of Longyan City were selected,with the case selection period ranging from September 2021 to September 2024.The patients were divided into two groups according to the surgical method.The observation group consisted of 48 patients who underwent the Glisson sheath exterior blood flow occlusion method,while the control group included 48 patients who underwent the Pringle total hepatic inflow occlusion method.Results The observation group had shorter operation time and hospital stay,as well as less intraoperative blood loss compared to the control group(P<0.05).At 3 days postoperatively,the observation group showed lower levels of total bilirubin(TBIL),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)than the control group(P<0.05).However,there were no statistically significant differences in albumin(ALB)and prothrombin time(PT)between the two groups(P>0.05).The total incidence of complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusions Both the Glisson sheath exterior blood flow occlusion method and the Pringle total hepatic inflow occlusion method can achieve certain therapeutic effects in the treatment of primary liver cancer through laparoscopic left hemihepatectomy.However,the Glisson sheath exterior blood flow occlusion technique offers several advantages.It results in a more streamlined surgical duration,effectively controls intraoperative blood loss,and is associated with a lower incidence of postoperative complications.
作者
潘伟华
简以增
危慧君
PAN Weihua;JIAN Yizeng;WEI Huijun(Department of Hepatobiliary Surgery,Second Hospital of Longyan City,Longyan,Fujian 364000,China)
出处
《中国医药指南》
2025年第20期102-105,共4页
Guide of China Medicine
