腹腔镜下精准肝切除术在肝包虫患者中的价值

Value of Laparoscopic Precise Hepatectomy in Patients With Hepatic Echinococcosis

目的探讨腹腔镜下精准肝切除术在肝包虫患者中的价值。方法2018年1月—2019年6月,收集本院收治的肝包虫病患者80例,其中腹腔镜下精准肝切除患者40例(观察组),开腹手术肝切除术40例(对照组)。观察两组患者治疗效果、并发症和康复情况。结果两组患者均无肝包虫病复发、囊液外溢等情况发生。观察组1例发生腹水,对照组1例肝功能不全,2例腹水,1例切口感染,两组并发症差异无统计学意义(P>0.05)。与对照组比较,观察组患者术中出血量、住院时间、术后拔管时间均减少(P<0.05)。两组患者术前肝功能储备参数(SRLV)差异无统计学意义[(584.64±78.74)mL/m^2vs.(578.74±80.12)mL/m^2,P>0.05]。术后3d时观察组SRLV显著高于对照组[(548.83±74.37)mL/m^2vs.(487.48±67.81)mL/m^2,P<0.05]。结论腹腔镜下精准肝切除术在肝包虫患者中较为安全,可以显著加速患者康复,保护肝功能。

Objective To investigate the value of laparoscopic precise hepatectomy in patients with hepatic echinococcosis.Methods From January 2018 to June 2019,80 patients with hepatic echinococcosis were collected,including 40 patients with laparoscopic precise hepatectomy(observation group)and 40 patients with open hepatectomy(control group).The therapeutic effect,complications and rehabilitation of the two groups were observed.Results No recurrence of hepatic echinococcosis or cystic fluid spillover occurred in both groups.There were 1 case of ascites in the observation group,1 case of hepatic insufficiency,2 cases of ascites and 1 case of incision infection in the control group.There was no significant difference in complications between the two groups(P>0.05).When compared with the control group,the blood volume,hospitalization time and extubation time of the patients in the observation group were decreased(P<0.05).There was no significant difference in preoperative liver function reserve parameters(SRLV)between the two groups[(584.64±78.74)mL/m^2 vs.(578.74±80.12)mL/m^2,P>0.05].The SRLV in the observation group was significantly higher than that in the control group at 3 days after operation[(548.83±74.37)mL/m^2 vs.(487.48±67.81)mL/m^2,P<0.05].Conclusion Laparoscopic precise hepatectomy is safe in patients with hepatic echinococcosis,which can significantly accelerate the recovery of patients and protect liver function.