前入路与常规入路肝癌切除术治疗大肝癌的临床应用研究

The Clinical Application Study of the Efficacy of Hepatectomy with Anterior and Conventional Approaches in the Treatment of Large Hepatic Carcinoma

目的探讨采用前入路肝癌切除术和常规入路肝癌切除术治疗大肝癌的临床应用。方法选择2011年1月至2014年5月我院收治的72例大肝癌患者为研究对象,随机分为实验组和对照组各36例,实验组行前入路肝癌切除术,对照组行常规入路肝癌切除术。比较两组患者手术时间、术中出血量、住院时间、住院费用、术后并发症发生情况以及术后1年、3年的无瘤生存率。结果两组患者手术时间比较差异无统计学意义(P>0.05);实验组术中出血量、住院时间以及住院费用均优于对照组,组间比较差异均有统计学意义(P<0.05);实验组术后1年、3年的生存率分别为58.5%、35.6%,对照组术后1年、3年的生存率分别为38.0%、16.2%,实验组优于对照组,组间比较差异均有统计学意义(P<0.05)。结论前入路肝癌切除术治疗大肝癌效果确切,有助于减少术中出血量、缩短住院时间、降低住院费用,提高患者生存率,可作为临床首选。

Objective To investigate the clinical efficacy of hepatectomy with anterior and conventional approaches for patients with large hepatic carcinoma.Methods A total of 72 patients with large hepatic carcinoma in our hospital from Jan 2011 to May 2014 were selected as research subjects,who were equally divided into a study group and a control group.The study group was treated by hepatectomy with an anterior approach while the control group was treated by hepatectomy with a conventional approach.And then the datum of operation time,perioperative bleeding,hospital stays,hospitalization expense,postoperative complications and survival rates after 1year and 3years were compared and analyzed.Results 1）There was no statistically significant difference in operation time between the two groups（P〈0.05）;2）Compared to the control group,the peroperative bleeding,hospital stays and hospitalization expense in the study group were superior to the control group（all P〈0.05）;3）The diseasefree survival rates after 1-year and 3-year operations in the study group were 58.5% and 35.6% respectively,and those of the control group were 38.0% and 16.2% respectively,which is inferior to the study group（P〈0.05）.Conclusion The hepatectomy with the anterior approach has an ideal effect to treat large hepatic carcinoma,which is really useful to decrease peroperative bleeding,shorten hospital stays,reduce hospitalization expense and improve survival rate of patients.Therefore,it can be the first option for large hepatic carcinoma.