以解剖性肝切除为基础的精准肝切除治疗肝胆恶性肿瘤的临床研究

Clinical Study of Precision Liver Resection Based on Anatomical Liver Resection in the Treatment of Hepatobiliary Malignancies

目的探讨对肝胆恶性肿瘤患者采用精准肝切除(以解剖性肝切除为基础)方法进行治疗后获得临床效果。方法方便选取该院2017年6月—2019年1月收治的84例肝胆恶性肿瘤患者,采用数字奇偶法分组。治疗组(42例):采用精准肝切除(以解剖性肝切除为基础)方法展开疾病治疗。常规组(42例):采用常规疗法展开疾病治疗;就组间术中失血量、临床手术时间与术后并发症表现进行观察对比。结果治疗组肝胆恶性肿瘤患者术中失血量(110.09±35.77)mL、手术时间(358.22±35.93)min分别少于以及短于常规组(252.11±38.82)mL、(469.23±35.99)min,差异有统计学意义(t=17.436、14.146,P<0.05);治疗组肝胆恶性肿瘤患者术后并发症发生率(9.52%)低于常规组(42.86%),差异有统计学意义(χ^(2)=12.070,P<0.05),通过后续治疗,所有并发症均获得有效治疗,转为正常。对患者实施为期7~18个月随访,平均随访时间为(11.13±2.25)个月;患者手术过程中以及手术后均未表现出死亡现象;随访期内,治疗组肝细胞癌患者表现出肝内复发患者1例,胆囊癌患者表现出肝转移患者1例。结论精准肝切除(以解剖性肝切除为基础)方法应用于肝胆恶性肿瘤患者,可减少术中失血量、缩短手术时间、降低术后并发症发生率,使得肝胆恶性肿瘤患者治疗安全性、有效性获得显著提升、增强,最终实现肝胆恶性肿瘤患者有效预后。

Objective To explore the clinical results obtained after precise hepatectomy(based on anatomical liver resection)for patients with hepatobiliary malignancies.Methods Conveniently selection the 84 patients with hepatobiliary malignancies admitted to the hospital from June 2017 to January 2019 were divided into groups by the digital parity method.Treatment group(42 cases)was carried out with precision liver resection(based on anatomical liver resection).Conventional group(42 cases)was treated with conventional therapy.The intraoperative blood loss,clinical operation time and postoperative complications were observed and compared between the groups.Results The intraoperative blood loss(110.09±35.77)mL and clinical operation time(358.22±35.93)min of patients with hepatobiliary malignancies in the treatment group were less than and shorter than those of the conventional group(252.11±38.82)mL and(469.23±35.99)min,and the difference was statistically significant(t=17.436,14.146,P<0.05);the postoperative complication rate of patients with hepatobiliary malignancies in the treatment group(9.52%)was significantly lower than that in the conventional group(42.86%),and the difference was statistically significant(χ^(2)=12.070,P<0.05),after follow-up treatment,all complications were effectively treated and turned to normal.The patients were followed up for 7 to 18 months,with an average follow-up time of(11.13±2.25)months;the patients did not show death during or after the operation;during the follow-up period,the patients with hepatocellular carcinoma in the treatment group showed 1 patient with liver internal recurrence,and 1 patient with gallbladder cancer showed liver metastasis.Conclusion The Precision liver resection(based on anatomical liver resection)is applied to patients with hepatobiliary malignancies,which can reduce intraoperative blood loss,shorten operation time,and reduce postoperative complications,making the treatment of patients with hepatobiliary malignancies safe and effective obtain significant improvement and enhancement,and finally achieve an effective prognosis for patients with hepatobiliary malignant tumors.