腹腔镜手术切除与腹腔镜微波消融治疗肝血管瘤的疗效比较

Comparison of laparoscopic resection and laparoscopic microwave ablation in the treatment of hepatic hemangioma

目的比较腹腔镜手术切除术与腹腔镜微波消融术这两种术式治疗肝血管瘤的疗效。方法回顾分析自2016年6月至2019年6月湖北医药学院附属襄阳市第一人民医院肝血管瘤患者46例病例资料,按术式分为腹腔镜手术切除术组(A组)和腹腔镜微波消融术组(B组),A组18例,B组28例。从手术时长、术中出血量、住院时间、术后肝功能恢复等方面比较A组和B组对肝血管瘤的疗效。结果与A组相比,B组在缩短手术时长(t=2.797,P=0.008)、降低出血量(t=3.253,P=0.005)、减少住院时间(t=2.065,P=0.045)方面有明显优势。术后第1天ALT、AST水平B组高于A组,差异有统计学意义(P<0.05)。术后第3天ALT、AST水平,术后第1天及第3天总胆红素、直接胆红素、间接胆红素水平,术后并发症发生率,肿瘤复发率,两组差异无统计学意义(P>0.05)。结论腹腔镜微波消融术安全可行,疗效明确,值得临床推广。

Objective To compare the efficacy of laparoscopic resection and laparoscopic microwave ablation in the treatment of hepatic hemangioma.Methods The clinical data of 46 patients with hepatic hemangioma in our hospital from June 2016 to June 2019 were retrospectively analyzed.They were divided into laparoscopic surgery group(group A)and laparoscopic microwave ablation group(group B),with 18 cases in group A and 28 cases in group B.The therapeutic effects of group A and group B on hepatic hemangioma were compared in terms of operation time,intraoperative blood loss,hospital stay and postoperative liver function recovery.Results Compared with group A,group B had obvious advantages in shortening operation time(t=2.797,P=0.008),reducing blood loss(t=3.253,P=0.005)and reducing hospital stay(t=2.065,P=0.045).On the first day after operation,ALT and AST levels in group B were higher than those in group A(P<0.05).The levels of ALT and AST on the third day after operation,the levels of total bilirubin,direct bilirubin and indirect bilirubin on the first and third days after operation,the incidence of postoperative complications and tumor recurrence rate between the two groups were not statistically significant(P>0.05).Conclusion Laparoscopic microwave ablation is safe,feasible and effective,which is worthy of clinical promotion.