肝蒂横断式肝切除在解剖性肝中叶切除术中的应用

Application of Hepatic Pedicle Transection Hepatectomy in the Anatomical Mesohepatectomy

目的观察解剖性肝中叶切除术应用肝蒂横断式肝切除的效果。方法方便选取2016年2月—2018年7月该院接诊的肝中叶原发性肝癌病患66例为研究对象,按照电脑随机双盲法分成研究组和对照两组(n=33)。研究组采取肝蒂横断式肝切除方案,对照组采取传统手术方案。分析两组手术治疗的情况,比较并发症发生率等指标。结果研究组的手术时间比对照组短,术中出血量比对照组少,组间差异有统计学意义(t=12.720 2,t=53.183 6,P<0.05)。研究组的并发症发生率为6.06%,比对照组的33.33%低,组间差异有统计学意义(χ~2=7.759 1,P<0.05)。实验组的住院时间为(12.34±2.69)d,比对照组的(16.85±2.51)d短,组间差异有统计学意义(t=7.041 8,P<0.05)。研究组术后第1天的转氨酶水平为(217.93±14.58)U/L、术后第7天为(62.97±7.49)U/L,比对照组的(575.62±15.31)U/L、(323.11±12.86)U/L低,组间差异有统计学意义(t=97.190 4,t=100.414 7,P<0.05)。结论选择肝蒂横断式肝切除方案对患者施以解剖性肝中叶切除术治疗,可取得显著疗效,不仅有助于缩短手术用时,还能有效预防术后并发症,降低术中出血量,促进术后恢复,建议采纳。

Objective To observe the effect of hepatic pedicle transection hepatectomy in the anatomical mesohepatectomy.Methods 66 cases of patients with primary liver cancer diagnosed in our hospital from February 2016 to July 2018 were convenient selected as the research objects and randomly divided into two groups with 33 cases in each,the research group were treated with hepatic pedicle transection hepatectomy,while the control group used the traditional surgery plan,and the operation treatment condition and incidence rate of complications were compared between the two groups.Results The operation time in the research group was shorter than that in the control group,and the intraoperative bleeding amount was lower than that in the control group,and the difference was statistically significant(t=12.720 2,t=53.183 6,P﹤0.05),and the incidence rate of complications in the research group was lower than that in the control group(6.06%vs 33.33%)and the difference was statistically significant(χ^2=7.759 1,P﹤0.05),and the length of stay in the experimental group was shorter than that in the control group,[(12.34±2.69)d vs(16.85±2.51)d],and the difference between groups was statistically significant(t=7.0418,P﹤0.05),and the transaminase levels in 1 d after surgery and in 7d after surgery in the experimental group were lower than those in the control group,[(217.93±14.58)U/L,(62.97±7.49)U/L vs(575.62±15.31)U/L,(323.11±12.86)U/L],and the difference was statistically significant(t=97.190 4,t=100.414 7,P﹤0.05).Conclusion The selection of hepatic pedicle transection hepatectomy in the anatomical mesohepatectomy is obvious,which can not only contribute to shortening the operative time,but also effectively preventing the postoperative complications,reducing the intraoperative bleeding amount and promoting the postoperative recovery,and it is suggested to be used.