常规肝切除术与精准肝切除术治疗肝细胞癌的临床疗效比较

The comparison of clinical efficiency between normal liver resection and precise liver resection for patients with primary liver cancer

目的分析比较常规肝切除术与精准肝切除术治疗肝细胞癌的临床疗效。方法选择74例行手术治疗的肝细胞癌患者,随机分为精准组和常规组。精准组患者38例,采用精准肝切除术治疗;常规组患者36例,采用常规肝切除术治疗。比较两组患者的手术时间、手术出血量、术后肝功能和术后并发症情况。随访1年,比较两组患者的复发率与生存率差异。结果与常规组患者比较,精准组患者的手术出血量、术后ALB、ALT和TBIL升高水平明显较少(P<0.05),而手术时间明显延长(P<0.05);术后并发症发生率显著降低(P<0.05);随访期两组患者复发率及生存率差异无统计学意义(P>0.05)。结论在肝细胞癌手术治疗中,精准肝切除术较常规肝切除术临床疗效及安全性更好,但随访结局无差异。

Objective To analyze and compare the clinical efficiency between normal liver resec- tion and precise liver resection for patients with primary liver cancer （PLC）. Methods A total of 74 pa- tients with PLC by segmentectomy were collected to study, and randomly divided into two groups, precise group （38 cases, received precise liver resection） and normal group （36 cases, received normal liver resec- tion）. The indexes of operation time, operation bleeding amount, post-operation liver function and compli- cations were compared between two groups. After one-year follow-up, the indexes of recurrence rate and sur- vival rate were compared between two groups. Results Compared to normal group, the indexes of operation bleeding amount, post-operation liver function （ALB, ALT and TBIL） were lower in precise group （P 〈 0. 05）, but the index of operation time was longer than normal group （P 〈 0. 05）, and the indexes of com- plication recurrence rates were lower （ P 〈 0. 05 ）. The indexes of recurrence rate and survival rate were no different between two groups （ P 〉 0. 05 ）. Conclusion Compared to normal liver resection, the clinical ef- ficiency and safety of precise liver resection were better and follow-up outcomes were no different.