肝内胆管癌行微创手术后的短期预后和长期预后观察

Short-term efficacy and long-term prognosis of intrahepatic minimally invasive surgery for bile duct cancer

目的探讨肝内胆管癌行微创手术后的短期和长期预后状况。方法选取2016年1月至2019年6月间武警北京市总队医院收治的86例肝内胆管癌患者,按照手术方式不同分为两组,采用腹肝切除术的40例患者纳入对照组,采用腹腔镜肝切除术的46例患者纳入观察组。比较两组患者的术后疼痛程度、卧床时间、住院时间、肝功能水平及临床疗效。结果观察组患者疼痛程度评分、卧床时间和住院时间均低于对照组,差异均有统计学意义(均P<0.05)。观察组患者各项肝功能指标均低于对照组,差异均有统计学意义(均P<0.05)。观察组患者6个月缓解率为82.6%,高于对照组的70.0%,差异有统计学意义(P<0.05)。结论腹腔镜肝切除术用于肝内胆管癌患者治疗中,能够缓解患者疼痛,缩短卧床时间和住院时间,改善肝功能,提高临床疗效,临床值得推广。

Objective To explore the short-term efficacy and long-term prognosis of intrahepatic minimally invasive surgery for bile duct cancer.Methods Eighty-six patients with intrahepatic bile duct cancer who admitted to Armed Police Beijing General Team Hospital from January 2017 to June 2019 were selected as the research subjects.The patients were divided into two groups according to the surgical method.Forty-six patients who underwent intrahepatic hepatectomy were included in the observation group and40 patents who underwent laparotomic hepatectomy were included in the control group.The two groups were compared for postoperative pain,bed rest duration,length of hospital stay,liver function,clinical efficacy,relapse and survival at 6 months after the surgery.Result The scores of pain,bed rest duration and length of hospital stay were lower in the observation group than in the control group(all P<0.05).Liver function indexes were lower in the observation group than in the control group(P<0.05).The 6-month remission rate was 82.6%in the observation group which was higher than 70.0%of the control group(P<0.05).Conclusion Laparoscopic hepatectomy in the treatment of intrahepatic cancer can alleviate pain,shorten bed rest duration and hospital stay,improve liver function and clinical efficacy,reduce the recurrence rate,and is worthy of clinical popularization.