不规则肝切除术和规则肝切除术在肝癌手术切除中的比较

Comparision between regular liver resection and irregular liver resection in liver cancer

目的探究不规则肝切除术和规则肝切除术在巨大肝癌手术切除中的临床应用及比较。方法本研究回顾性分析2006年6月至2014年6月罗定市人民医院收治的原发性肝癌肝切除手术患者,对已实施的不规则性肝切除术与规则性肝切除术两组病例进行比较。包括两组手术的围手术期各个指标及术中、术后各个指标进行比较。结果规则肝切除组中的手术时间、术中出血、输血浆、输红细胞量、住院时间及并发症发生率均明显地高于不规则肝切除组的情况,差异有统计学意义(P<0.05),而肿瘤能完整切除的最大直径显著小于不规则肝切除(P<0.05);二者在死亡率的比较上无明显差异,无统计学意义(P>0.05)。结论与规则肝切除相较,不规则肝切除在腹部手术史引起严重腹腔内组织粘连、肝功能分级较差、肿瘤数目较多及小肝癌中均体现了明显的优势。而对于肿瘤体积较大的肝癌患者,规则肝切除则更为有效。

Objective To compare the clinical effects of regular liver resection and irregular liver resection in liver cancer. Methods The retrospective study was performed in liver cancer patients with the surgical procedure of hepatic resection from June 2006 to June 2014. Of 138 cases,83 underwent regular liver resection, and 55 were received irregular liver resection. The indicators of perioperative, intraoperative and postoperative between irregular liver resection group and regular liver resection group were compared. Results The operation time, intraoperative blood loss, the transfusion amount of plasma and red blood cells, length of hospital stay and the rates of complication in regular liver resection group were significantly higher than the irregular liver resection group, and the difference was statistically significant（all P values were less than 0.05）. For the diameter in the removal tumor,the irregular liver resection group was significantly higher than the regular liver resection group（P〈0.05）. There was no statistical difference between the two groups of patients in the comparison of mortality（P〉0.05）. Conclusion In the present study, compared with the regular liver resection, irregular liver resection reflected the clear advantage in liver cancer patients.