不同术式对肝血管瘤患者预后的影响

Effect of Different Operative Methods on Prognosis of Patients with Hepatic Hemangioma

目的探讨不同手术治疗对肝血管瘤患者预后的影响因素.方法收集80例肝血管瘤患者的临床资料,按照不同手术方式分为腹腔镜组、开腹组、介入栓塞组,比较3组手术情况,并于术后随访1 a,根据两组是否复发及肝功能衰竭情况分为预后良好组与预后不良组,分析影响两组患者预后的因素.结果 3组患者的性别、分布情况、单发例数等一般资料比较差异均无统计学意义(P>0. 05),介入栓塞组年龄显著高于其他两组,腹腔镜组瘤体直径显著高于其他两组(P<0. 05);开腹组手术时间((112. 4±21. 3) min)与腹腔镜组((102. 3±10. 8) min)比较差异无统计学意义(P>0. 05);但术中出血量、切口长度、住院时间均显著高于腹腔镜组、介入栓塞组,且介入栓塞组最低,组间差异显著(P<0. 05);多因素Logistic回顾分析中,瘤体直径、单多发情况、术中出血量、手术类型均是影响患者预后的独立危险因素(P<0. 05).结论介入栓塞术、腹腔镜组、开腹术均可有效治疗肝血管瘤,其中腹腔镜手术对机体影响较小,但术后患者康复效果与瘤体直径、术中出血量、手术类型密切相关.

Objective To investigate the factors affecting the prognosis of patients with hepatic hemangioma treated by different operative methods.Method The clinical data of 80 patients with hepatic hemangioma were selected and divided into the laparoscopic group,the open group and the interventional embolization group according to different operative methods.The situation of operation was compared among groups,and they were all followed up for 1 year after operation.According to the incidence of recurrence and liver failure,they were divided into the good prognosis group and the poor prognosis group.The factors affecting the prognosis of two groups were analyzed.Results There was no statistically significant difference in general data such as gender,distribution and number of single cases among the three groups(P>0.05).Patients in the interventional embolization group were significantly older than those in other two groups,and the diameter of tumor was significantly longer than that in other two groups(P<0.05).There was no statistically significant difference in operation time between the open group and the laparoscopic group(112.4±21.3)min vs(102.3±10.8)min(P>0.05).However,the intraoperative blood loss,length of incision and length of hospital stay showed the open group>the laparoscopic group>the interventional embolization group,with statistically significant differences between groups(P<0.05).Multivariate Logistic retrospective analysis showed that the diameter of tumor,intraoperative blood loss and the type of operation were independent risk factors affecting the prognosis of patients(P<0.05).Conclusion Interventional embolization,laparoscopic operation and open operation are effective in the treatment of hepatic hemangioma.The laparoscopic operation has little effect on the body.The postoperative rehabilitation effect of patients is closely related to the diameter of tumor,intraoperative blood loss and type of operation.Comprehensive assessment of the patient’s condition is necessary to choose the appropriate operation,improve the prognosis of patients.