微波消融治疗肝右叶巨大血管瘤的效果

Effect of microwave ablation on giant hemangioma in the right lobe of liver

目的探讨微波消融治疗肝右叶巨大血管瘤的效果。方法回顾性分析2016年1月至2020年6月我院普通外科收治的120例肝右叶巨大血管瘤患者的临床资料。依据手术方式将患者分为微波消融组(微波组)和腹腔镜切除组(切除组),各60例。比较两组的手术及临床恢复相关指标、术后第3天的实验室检测指标、术后并发症发生情况。结果微波组患者未进行术中输血,切除组患者平均术中输血量为(273.2±232.0)mL。微波组无肝门阻断患者,切除组有48例肝门阻断患者。微波组的术中失血量显著少于切除组,手术时间、胃肠功能恢复时间、引流管拔除时间及术后住院时间均显著短于切除组(P<0.05)。术后第3天,微波组的WBC、ALT、AST、TBIL水平显著低于切除组,ALB水平显著高于切除组,PT显著短于切除组(P<0.05);两组的Cr水平比较,差异无统计学意义(P>0.05)。微波组的腹腔出血、胆漏、右侧胸腔积液发生率低于切除组,血红蛋白尿发生率高于切除组(P<0.05)。结论微波消融治疗肝右叶巨大血管瘤是安全、有效的,且更微创。

Objective To explore the effect of microwave ablation on giant hemangioma in the right lobe of liver.Methods The clinical data of 120 patients with giant hemangioma in the right lobe of liver treated in the general surgery department of our hospital from January 2016 to June 2020 were analyzed retrospectively.The patients were divided into microwave ablation group(microwave group)and laparoscopic resection group(resection group),with 60 cases in each group.The related indexes of operation and clinical recovery,laboratory test indexes on the 3rd day after operation and postoperative complications were compared between the two groups.Results No intraoperative blood transfusion was performed in the microwave group,and the average intraoperative blood transfusion volume in the resection group was(273.2±232.0)mL.No patients performed hilar occlusion in the microwave group,while 48 patients performed hilar occlusion in the resection group.The intraoperative blood loss in the microwave group was significantly less than that in the resection group,and the operation time,gastrointestinal function recovery time,drainage tube extraction time and postoperative hospital stay in the microwave group were significantly shorter than those in the resection group(P<0.05).On the 3rd day after operation,the WBC,ALT,AST and TBIL levels in the microwave group were significantly lower than those in the resection group,the level of ALB was significantly higher than that in the resection group,and the PT was significantly shorter than that in the resection group(P<0.05);there was no significant difference in Cr level between the two groups(P>0.05).The incidences of intraperitoneal hemorrhage,bile leakage and right pleural effusion in the microwave group were lower than those in the resection group,while the incidence of hemoglobinuria was higher than that in the resection group(P<0.05).Conclusion Microwave ablation for giant hemangioma in the right lobe of liver is safe,effective and minimally invasive.