精准肝切除术治疗原发性肝癌的临床效果分析

Clinical Effects of Precise Liver Resection with Laparoscope Surgery on the Treatment of the Primary Hepatocellular Carcinoma

目的:探讨腹腔镜精准肝切除术的特点及效果,为普外科手术提供参考。方法:选取2011年10月-2013年7月我院收治的92例原发性肝癌患者的临床资料进行回顾分析。根据手术方式不同,将病例分为常规肝切除组和精准肝切除组,每组46例。观察并比较两组患者的评均术中出血量、手术时间、住院时间、手术前后的肝功能指标变化、并发症的发生率、肿瘤局部复发率及远期转移率等。结果:与常规肝切除组相比较,精准肝切除组患者的平均术中出血量少、住院时间短、术后并发症的发生率及肿瘤复发转移率低,但手术时间较长,组间比较差异显著,具有统计学意义(P<0.05)。与手术前比较,两组患者手术后的血清TBIL、ALT及AST含量降低,ALB升高,精准肝切除组患者各项指标的变化程度更显著,肝功能优于常规肝切除组,组内及组间比较差异具有统计学意义(P<0.05)。结论:精准肝切除术对于原发性肝癌的治疗具有良好临床的效果,不仅能够彻底清除病灶,而且降低了术后肝衰竭等并发症的发生率,值得推广应用。

Objective： To explore the clinical efficacy of the precise liver resection by laparoscope on the treatment of the primary hepatocellular carcinoma so as to make a reference to the clinical surgery. Methods： A retrospective analysis was performed about the clinical data of 92 patients with PHC who were treated in our hospital from October 2011 to July 2013. According to the different operation methods, the selected patients were divided into the conventional resection group and the precise resection group with 46 cases in each one. The patients in the conventional resection group were received the routine operation, while the patients in the precise resection group were treated by the laparoscope. Then the operation time, the blood loss, the liver function, the rate of recurrence, the incidence of complications and the hospitalization of patients in the two groups were compared and analyzed. Results： The blood loss, the hospitalization, the incidence of complications and the rate of recurrence of patients in the precise resection group were significantly lower than those of the conventional group with statistical differences （P〈0.05）; The time for operation in the precise group was longer than that of the conventional group（P〈0.05）; The indexes of liver function of the patients in the precise resection group were significantly better than those of the conventional group with statistical differences（P〈0.05）. Conclusions： The precise liver resection with laparoscope is worthy of promoting to treat the primary hepatocellular carcinoma with the obvious clinical efficacy, the shorter time and the lower incidence of complications.