实时超声导航下解剖性肝段切除术治疗原发性肝癌的临床效果及对术后生活质量、复发率的影响

Clinical effect of anatomical hepatectomy under real-time ultrasound navigation in the treatment of primary liver cancer and its influence on postoperative quality of life and recurrence rate

目的探究实时超声导航下解剖性肝段切除术治疗原发性肝癌的临床效果及对术后生活质量、复发率的影响。方法选取2013年3月至2018年3月我院收治的58例原发性肝癌患者作为研究对象,根据治疗方案不同将其分为对照组与观察组,各29例。对照组给予非解剖性肝段切除术治疗,观察组给予实时超声导航下解剖性肝段切除术治疗。比较两组的治疗效果。结果两组的出血量比较,差异无统计学意义(P>0.05);观察组的手术时间长于对照组,肝门阻断率、输血率均低于对照组(P<0.05)。两组的并发症总发生率比较,差异无统计学意义(P>0.05)。术后2 d,两组的AST、ALT水平均高于术前,但观察组低于对照组(P<0.05)。术后2个月,两组的QOL-LC评分均升高,且观察组高于对照组(P<0.05)。术后1年,观察组的肝内复发率低于对照组,存活率高于对照组(P<0.05)。结论实时超声导航下解剖性肝段切除术治疗原发性肝癌患者,可降低肝门阻断率、输血率,减少肝功能损伤,提高患者术后生活质量,并可降低复发率,提高1年存活率。

Objective To investigate the clinical effect of anatomical hepatectomy under real-time ultrasound navigation in the treatment of primary liver cancer and its influence on postoperative quality of life and recurrence rate.Methods From March 2013 to March 2018,58 patients with primary liver cancer admitted in our hospital were selected as the study objects.According to the different treatment schemes,the patients were divided into control group and observation group,with 29 cases in each group.The control group was treated with non anatomical hepatectomy,and the observation group was treated with anatomical hepatectomy under real-time ultrasound navigation.The therapeutic effects were compared between the two groups.Results There was no significant difference in the amount of bleeding between the two groups(P>0.05);the operation time in the observation group was longer than that in the control group,and the rates of hepatic portal occlusion and blood transfusion were lower than those in the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Two days after operation,the levels of AST and ALT in the two groups were higher than those before operation,but those in the observation group were lower than the control group(P<0.05).Two months after operation,the score of QOL-LC in the two groups increased,and that in the observation group was higher than the control group(P<0.05).One year after operation,the recurrence rate of intrahepatic in the observation group was lower than that in the control group,and the survival rate was higher than that in the control group(P<0.05).Conclusion Anatomical hepatectomy under real-time ultrasound navigation in the treatment of primary liver cancer can reduce the rate of hepatic portal occlusion,blood transfusion,and the damage of liver function,improve the quality of life of patients after operation,reduce the recurrence rate and improve the one-year survival rate.