腹腔镜精准肝切除治疗原发性肝癌的临床效果评价

Clinical Evaluation of Laparoscopic Precise Hepatectomy for Primary Liver Cancer

目的探究腹腔镜精准肝切除治疗原发性肝癌的临床效果。方法方便选择2016年1月-2019年2月期间收治原发性肝癌90例,按照随机数字表法划分为对照组及观察组进行研究,每组45例。对照组行常规切除术,观察组行腹腔镜精准肝切除术。比较两组患者手术相关指标、肝功能、并发症以及1年复发率情况。结果观察组手术时间为(100.08±6.78)min,对照组手术时间为(98.32±6.55)min;观察组术中失血量、住院时间分别为(206.78±10.08)mL、(8.56±1.01)d,均低于对照组(355.90±10.10)mL、(10.67±2.01)d,(t=-1.252、70.103、6.292,P=0.214、0.000、0.000)。观察组术后丙氨酸氨基转移酶、天冬氨酸转氨酶分别为(10.87±2.11)U/L、(15.02±2.05)U/L,均低于对照组(23.54±2.77)U/L、(29.32±2.78)U/L;观察组术后白蛋白以及总胆红素分别为(56.18±3.65)μmol/L、(42.34±3.12)μmol/L(t=9.880、27.772,P<0.05)均高于对照组(42.78±3.01)μmol/L、(17.23±1.52)μmol/L(t=-19.000、-48.535,P<0.05)。观察组术后并发症发生率及1年的复发率分别为6.67%、4.44%,明显低于对照的22.22%、17.78%,(χ~2=4.406、4.050,P=0.036、0.044)。结论腹腔镜精准肝切除治疗原发性肝癌效果显著,术中失血量少且住院时间短,促使患者术后康复,且有效控制术后并发症及复发率,体现良好的远期疗效,值得推广。

Objective To explore the clinical effect of laparoscopic precision hepatectomy for primary liver cancer.Methods Convenient selection of ninety cases of primary liver cancer were treated between January 2016 and February2019. They were divided into control group and observation group according to the random number table method, with 45 cases in each group. The control group underwent routine resection and the observation group underwent laparoscopic precision hepatectomy. Surgical related indicators, liver function, complications, and 1-year recurrence rate were compared between the two groups. Results The operation time of the observation group was(100.08±6.78) min, and the operation time of the control group was(98.32±6.55) min. The blood loss and hospitalization time of the observation group were(206.78±10.08)mL,(8.56±1.01)d., which are lower than the corresponding values?of the control group(355.90 ±10.10)mL,(10.67 ±2.01)d,(t =-1.252,70.103,6.292,P =0.214,0.00,0.000). The alanine aminotransferase and aspartate aminotransferase in the observation group were(10.87 ±2.11) U/L and(15.02 ±2.05) U/L, respectively, which were lower than the control group(23.54±2.77) U/L.(29.32±2.78) U/L;albumin and total bilirubin in the observation group were(56.18±3.65)μmol/L,(42.34±3.12) μmol/L(t=9.880,27.772,P<0.05), respectively, which were higher than those of the control group(42.78 ±3.01)μmol/L,(17.23 ±1.52) μmol/L(t =19.000,-48.535,P <0.05). The postoperative complication rate and 1-year recurrence rate in the observation group were 6.67% and 4.44%, respectively, which were significantly lower than the 22.22% and 17.78% of the control(χ~2=4.406, 4.050, P =0.036, 0.044). Conclusion Laparoscopic precise hepatectomy has a significant effect in the treatment of primary liver cancer, with little intraoperative blood loss and short hospital stay, promoting postoperative recovery of patients, and effectively controlling postoperative complications and recurrence rate, which reflects good longterm efficacy and is worthy of promotion.