3D腹腔镜在肝泡型包虫病治疗中的应用价值

Application value of 3D laparoscopy in the treatment of hepatic alveolar echinococcosis

目的探讨3D腹腔镜在肝泡型包虫病(HAE)治疗中的应用价值。方法回顾性分析2017年1月至2019年1月新疆医科大学第一附属医院收治的52例HAE患者临床资料。其中男23例,女29例;平均年龄(39±12)岁。患者均签署知情同意书,符合医学伦理学规定。按照不同手术方式分为3D腔镜组(12例)和开腹组(40例)。比较两组患者围手术期情况。两组术中出血量、术后带管时间等比较采用秩和检验,并发症发生率比较采用χ^2检验。结果3D腔镜组患者术中出血量、术后带管时间、术后住院时间分别为150(188)ml、4(1)d、6(2)d,明显低于开腹组的400(300)ml,7(4)d,9(4)d(Z=-3.568,-3.956,-2.675;P<0.05)。3D腔镜组术后并发症发生率25%(3/12),明显低于开腹组的68%(27/40)(χ^2=6.831,P<0.05)。结论3D腹腔镜技术在HAE治疗中的应用是安全、可行的,具有精准、微创等优势。

Objective To evaluate the application of 3D laparoscopy in the treatment of hepatic alveolar echinococcosis(HAE).Methods Clinical data of 52 HAE patients admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2017 to January 2019 were retrospectively analyzed.Among them,23 patients were male and 29 female,aged(39±12)years on average.The informed consents of all patients were obtained and the local ethical committee approval was received.All patients were divided into the 3D laparoscopy group(n=12)and open surgery group(n=40)according to different surgical methods.Perioperative conditions were compared between two groups.The intraoperative blood loss and the length of postoperative catheter retention were statistically compared between two groups by rank-sum test.The incidence of postoperative complications was compared by Chi-square test.Results In the 3D laparoscopy group,the intraoperative blood loss,length of postoperative catheter retention and postoperative length of hospital stay were 150(188)ml,4(1)d and 6(2)d,significantly less than 400(300)ml,7(4)d and 9(4)d in the open surgery group(Z=-3.568,-3.956,-2.675;P<0.05).The incidence of postoperative complications in the 3D laparoscopy group was 25%(3/12),which was significantly lower than 68%(27/40)in the open surgery group(χ^2=6.831,P<0.05).Conclusions Application of 3D laparoscopy is a safe and feasible option in the treatment of HAE,which has the advantages of precision and minimally invasive.