解剖性肝切除治疗肝泡型包虫病临床价值研究

The clinical value evaluation of anatomic hepatectomy in the treatment for hepatic vesicular hydatidosis

目的探讨解剖性肝切除手术对肝泡型肝包虫病肝切除病人的临床应用价值。方法回顾性分析2017年1月至2018年12月青海省人民医院行肝切除手术治疗的62例肝泡型包虫病病人的临床资料,按肝切除手术方法分为解剖性肝切除组(35例)和非解剖性肝切除组(27例),分别比较两组病人术前基本资料、术中情况及术后临床指标。结果两组病人在年龄、性别、包虫数量、包虫大小及术前肝功能指标差异均无统计学意义(P>0.05);而术中出血量、输血量、术后肝功能指标[天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、总胆红素(TBIL)和直接胆红素(DBIL)]、并发症发生率及术后住院时间差异有统计学意义(P<0.05)。结论解剖性肝切除技术同样适用于肝泡型包虫病病人的外科治疗,而且具有肝功能损伤小、并发症发生率低及术后住院时间短等优势。

Objective To explore the clinical application value of perioperative comprehensive management of precise hepatectomy in hepatectomy for hepatic alveolar echinococcosis. Methods The clinical data of 62 patients with hepatic alveolar echinococcosis who underwent hemihepatectomy from January 2017 to December 2018 were collected and divided into anatomical hepatectomy group(35 cases)and non-anatomical hepatectomy group(27 cases) according to the method of hepatectomy. The differences of preoperative basic data,intraoperative situation and postoperative clinical indexes between the two groups were compared respectively. Results There was no significant difference in age,sex,hydatid number,hydatid size and preoperative liver function index between the two groups(P>0.05). However,there were significant differences between the two groups in liver function indexes(ALT,AST,DBIL and TBIL),postoperative complication(medicine) incidence rate and postoperative hospital stay(P<0.05). Conclusion Accurate hepatectomy is also suitable for surgical treatment of patients with hepatic alveolar echinococcosis,and has the advantages of less liver function damage,low incidence of complication(medicine) and short hospitalization time after operation.