解剖性与非解剖性肝切除术治疗晚期肝癌的效果比较

Effect comparision of anatomic and non anatomic hepatectomy treating advanced liver carcinoma

目的比较解剖性与非解剖性肝切除术治疗晚期肝癌的临床效果。方法选取南阳医专一附院2011年1月-2013年6月行手术治疗的98例晚期肝癌患者作为研究对象。根据手术方式,将患者分为观察组和对照组。观察组（n=59）采用解剖性肝切除术,对照组（n=39）采用非解剖性肝切除术。比较两组的术中、术后相关指标。结果术中相关指标：观察组的手术时间为（271.5±97.4）min,长于对照组的（188.5±70.7）min,切缘有效率为89.8%,明显高于对照组的53.8%,差异有统计学意义（P〈0.05）;两组的术中出血量、术中输血量比较,差异无统计学意义（P〉0.05）。术后相关指标：观察组术后3 d血清ALT值为（270.5±94.1）U/L,显著低于对照组的（501.6±115.6）U/L;观察组术后1年复发率明显低于对照组,术后1年生存率明显高于对照组（P〈0.05）。结论对于有手术切除指征的晚期肝癌患者,解剖性肝切除术具有更高的安全性与临床疗效,值得临床推广应用。

Objective To compare the clinical effect of anatomic and non anatomic hepatectomy treating advanced liver carcinoma. Methods 98 patients with advanced liver cancer treated by surgery in the First Affiliated Hospital of Nanyang Medical College from January 2011 to June 2013 were selected as study objects.According to operation method,they were divided into observation group and control group,the observation group（n =59） was given anatomic hepatectomy,while control group（n=39） was given non anatomical hepatectomy, intraoperative and postoperative related indicators between two groups was compared respectively. Results Intraoperative and postoperative related indicators：operating time of observation group [（271.5＋97.4） min] was longer than that of control group [（188.5＋70.7） min],effective rate of cutting edge of observation group（89.8%） was obviously higher than that of control group（53.8%）,and there was a statistical difference（P〈0.05）;there was no statistical difference of intraoperative blood loss and blood transfusion amount between two groups（P〉0.05）.Postoperative related indicators：serum ALT value after 3 days operation in observation group [（270.5＋94.1） U/L] was obviously lower than that of control group [（501.6＋115.6） U/L],and recurrence rate after 1 year operation in observation group was obviously lower than that of control group,survival rate after 1 year operation in observation group was obviously higher than that of control group（P〈0.05）. Conclusion For patients with advanced liver cancer with surgical removal of indication,anatomic hepatectomy has higher safety and clinical efficacy.It is worthy of clinical promotion and application.