腹腔镜与开腹解剖性肝切除对伴有肝硬化肝细胞癌患者术后肝功能及预后的影响研究

Study of the Hepatic Function and Surgical Prognosis of Hepatocellular Carcinoma Patients with Liver Cirrhosis Using Laparoscopic and Open Anatomical Hepatectomy

目的比较腹腔镜与开腹解剖性肝切除治疗肝细胞癌伴肝硬化患者的价值。方法按回顾性分析法选择我院2017年5月至2020年5月纳入的56例肝细胞癌伴肝硬化患者,其中28例接受腹腔镜解剖性肝切除的患者作为研究组,另28例接受开腹解剖性肝切除的患者作为对照组,比较两组手术结果。结果研究组手术时间长于对照组,但失血量、引流管留置以及住院时长均低于对照组(P<0.05)。手术前两组的肝功能相比无显著差异(P>0.05),手术后研究组ALT、AST、DBIL、TBIL均高出对照组(P<0.05)。研究组并发症发生率7.14%低于对照组28.57%(P<0.05)。手术前两组的QOL评分相比无显著差异(P>0.05),手术后研究组各评分均高出对照组(P<0.05)。结论腹腔镜解剖性肝切除的效果更为显著,虽然手术时间较长,但失血量较低,缩短患者住院时长,增强肝功能,减低并发症的发生率,提升生存质量,值得推广。

Objective To compare the clinical value of laparoscopic and open anatomical hepatectomy in hepatocellular carcinoma patients with liver cirrhosis. Methods 56 hepatocellular carcinoma patients with liver cirrhosis treated from May 2017 to May 2020 in our hospital were reviewed. 28 cases of receiving the laparoscopic anatomical hepatectomy were set as research group;28 cases of receiving the open anatomical hepatectomy were set as control group. Surgical effects were probed. Results The operation time in the research group was longer than control group;but the bleeding volume, drainage tube indwelling time and hospital stays were shorter than control group(P<0.05);before surgery, hepatic function between groups was not significantly different(P>0.05);after surgery, ALT(alanine aminotransferase), AST(aspartate aminotransferase), DBIL(direct bilirubin) and TBIL(total bilirubin) levels in the research group were significantly higher than control group(P<0.05);the surgical complication rate in the research group(7.14%) was significantly lower than control group(28.57%)(P<0.05);before surgery, QOL(quality of life) scores between groups were not significantly different(P>0.05);after surgery, QOL scores in the research group were significantly higher than control group(P<0.05). Conclusion Although the operation is extended, the laparoscopic anatomical hepatectomy can reduce the bleeding volume and surgical complications, shorten the hospital stays, and improve the hepatic function and quality of life. It is worthy of promotion.