腹腔镜与开腹肝切除术治疗原发性肝癌的疗效比较(1)
[摘要] 目的 探讨并比较腹腔镜与开腹肝切除术治疗原发性肝癌的疗效。 方法 选取2016年1月～2018年1月在我院就诊的原发性肝癌患者共64例，随机分为观察组与对照组。观察组患者采用腹腔镜微创手术治疗，对照组患者采用开腹手术治疗。观察并比较两组患者的手术情况、术后恢复及并发症发生情况。 结果 观察组患者的手术时间、术中出血量、手术切缘、术后排气时间、拔管时间、住院时间均明显少于对照组(P<0.05)；两组患者的手术前肝功能比较无明显差异(P>0.05)。术后1周，两组患者的肝功能指标均较手术前改善(P<0.05或P<0.01)，且观察组患者的改善幅度较对照组更显著(P<0.05)；观察组患者的术后并发症发生情况少于对照组(P<0.05)。 结论 腹腔镜手术治疗原发性肝癌具有手术创伤少、术后恢复快、术后并发症少等优点，是一种安全有效的手术方式。
[关键词] 原发性肝癌；腹腔镜；开腹； 肝切除术
[中图分类号] R735.7 [文献标识码] B [文章编号] 1673-9701(2018)18-0034-04
[Abstract] Objective To investigate and compare the efficacy of laparoscopic and open hepatectomy in the treatment of primary liver cancer. Methods A total of 64 patients with primary liver cancer who were treated in our hospital during the period from January 2016 to January 2018 were selected. The patients were randomly divided into observation group and control group. The patients in the observation group were given laparoscopic minimally invasive surgery. The patients in the control group were given open surgery. The operation conditions， postoperative recovery and complications were observed and compared between the two groups of patients. Results The operation time， intraoperative blood loss， surgical margin， time of postoperative passage of gas， extubation time and length of stay in the observation group were significantly lower than those in the control group(P<0.05)； there was no significant difference in preoperative liver function between the two groups(P>0.05). One week after surgery， the liver function indices of the two groups was improved compared with the preoperative indices(P<0.05 or P<0.01)， and the improvement degree of the patients in the observation group was more significant than that in the control group(P<0.05). Postoperative complications in the observation group were less than those in the control group(P<0.05). Conclusion Laparoscopic surgery in the treatment of primary liver cancer has the advantages of less surgical trauma， rapid postoperative recovery， and less postoperative complications. It is a safe and effective surgical method.
[Key words] Primary liver cancer； Laparoscopy； Open surgery； Hepatectomy
原發性肝癌是临床发病率较高的恶性肿瘤之一，在我国发病率仅次于肺癌位居第二位[1-2]。原发性肝癌若不及时治疗，严重影响患者的预后，5年生存年率较低[3]。手术是治疗原发性肝癌最常用的方法，常规的开腹手术创伤大、术中出血多、术后恢复慢、对肝功能影响较大[4-5]。腹腔镜手术可以避免开腹手术创伤较大等缺点，取得更好的围手术期结果[6]。本研究观察并比较腹腔镜与开腹肝切除术治疗的疗效及并发症情况，现报道如下。
1 资料与方法
1.1 一般资料
选取2016年1月～2018年1月期间在我院住院治疗原发性肝癌患者共64例。纳入标准：(1)所有患者均符合《内科学》(第8版)中原发性肝癌的诊断标准[7]，经病理学或细胞学确诊为原发性肝癌；(2)肿瘤直径≤6 cm；(3)未发现远处转移。排除标准[8]：(1)合并其他位置肿瘤者；(2)合并其他严重的脏器疾病无法手术者；(3)伴有精神疾病者。采用随机数字表法将64例患者分为观察组和对照组各32例，两组患者的性别、年龄、病程时间、肿瘤直径及肝功能Child-Pugh分级等比较相接近(P>0.05)。见表1。, 百拇医药(张玉惠 张伟忠)
[关键词] 原发性肝癌；腹腔镜；开腹； 肝切除术
[中图分类号] R735.7 [文献标识码] B [文章编号] 1673-9701(2018)18-0034-04
[Abstract] Objective To investigate and compare the efficacy of laparoscopic and open hepatectomy in the treatment of primary liver cancer. Methods A total of 64 patients with primary liver cancer who were treated in our hospital during the period from January 2016 to January 2018 were selected. The patients were randomly divided into observation group and control group. The patients in the observation group were given laparoscopic minimally invasive surgery. The patients in the control group were given open surgery. The operation conditions， postoperative recovery and complications were observed and compared between the two groups of patients. Results The operation time， intraoperative blood loss， surgical margin， time of postoperative passage of gas， extubation time and length of stay in the observation group were significantly lower than those in the control group(P<0.05)； there was no significant difference in preoperative liver function between the two groups(P>0.05). One week after surgery， the liver function indices of the two groups was improved compared with the preoperative indices(P<0.05 or P<0.01)， and the improvement degree of the patients in the observation group was more significant than that in the control group(P<0.05). Postoperative complications in the observation group were less than those in the control group(P<0.05). Conclusion Laparoscopic surgery in the treatment of primary liver cancer has the advantages of less surgical trauma， rapid postoperative recovery， and less postoperative complications. It is a safe and effective surgical method.
[Key words] Primary liver cancer； Laparoscopy； Open surgery； Hepatectomy
原發性肝癌是临床发病率较高的恶性肿瘤之一，在我国发病率仅次于肺癌位居第二位[1-2]。原发性肝癌若不及时治疗，严重影响患者的预后，5年生存年率较低[3]。手术是治疗原发性肝癌最常用的方法，常规的开腹手术创伤大、术中出血多、术后恢复慢、对肝功能影响较大[4-5]。腹腔镜手术可以避免开腹手术创伤较大等缺点，取得更好的围手术期结果[6]。本研究观察并比较腹腔镜与开腹肝切除术治疗的疗效及并发症情况，现报道如下。
1 资料与方法
1.1 一般资料
选取2016年1月～2018年1月期间在我院住院治疗原发性肝癌患者共64例。纳入标准：(1)所有患者均符合《内科学》(第8版)中原发性肝癌的诊断标准[7]，经病理学或细胞学确诊为原发性肝癌；(2)肿瘤直径≤6 cm；(3)未发现远处转移。排除标准[8]：(1)合并其他位置肿瘤者；(2)合并其他严重的脏器疾病无法手术者；(3)伴有精神疾病者。采用随机数字表法将64例患者分为观察组和对照组各32例，两组患者的性别、年龄、病程时间、肿瘤直径及肝功能Child-Pugh分级等比较相接近(P>0.05)。见表1。, 百拇医药(张玉惠 张伟忠)
参见：首页 > 医疗版 > 疾病专题 > 消化内科 > 肝胆疾病 > 肝胆肿瘤 > 原发性肝癌