腹腔镜肝切除治疗肝肿瘤的临床研究

Clinical study on laparoscopic hepatectomy for liver tumors

目的探讨腹腔镜肝切除(LH)的临床应用价值及其对机体免疫功能的影响。方法选择符合纳入标准的45例行肝切除患者随机分入LH组和开腹肝切除(OH)组。比较两组患者的平均切口长度、手术时间、术中出血量、术后进食时间、术后止痛药的用量、术后住院天数、有无并发症、围手术期体温变化及血象的变化。结果 LH组在切口长度、出血量、进食时间、术后止痛药用量、术后住院时间及围手术期体温均明显少于OH组(均P<0.05),两组手术时间相仿,均无严重并发症(P<0.05)。结论在病例选择适当时,腹腔镜肝切除术安全、可行、临床效果确切,对机体免疫影响小,近期疗效明显优于开腹手术。

Objective To investigate the clinical value of laparoscopic hepatectomy（LH） and the effect on immunological system.Methods Forty-five patients who met the inclusion criteria to undego hepatectomy were randomly divided into LH group and open hepatectomy（OH） group.The parameters including length of incision,duration of operation,intraoperative blood loss,postoperative time to oral intake,dosages of analgesics,postoperative hospital stay,complication rate,perioperative body temperature and hemogram between the two groups were compared.Results The parameters of length of incision,blood loss,dosages of analgesics,time to food intake,postoperative hospital stay and body temperature of LH group were all significantly less than those of OH group（all P0.05）.No difference was noted in duration of operation between the two groups（P0.05）.Conclusions LH is a safe,feasible and effective procedure for liver resection as long as the patient is properly selected,and it has little effect on the immunological system and better short-term outcome than open surgery.