腹腔镜大范围肝切除术和开腹大范围肝切除术治疗肝癌的对比研究

Comparative study of laparoscopic extensive hepatectomy and open extensive hepatectomy in treatment of liver cancer

目的探讨腹腔镜大范围肝切除术(LMH)与开腹大范围肝切除术的治疗效果。方法选取2018年12月至2020年12月入院治疗的97例肝癌患者为研究对象,依据随机数字表法予以分组,A组49例采取LMH治疗,B组48例采取开腹大范围肝切除术治疗。比较两组围术期治疗指标、肝功能指标和并发症发生率。结果A组患者的切口长度为(9.08±0.65)cm、术中出血量为(342.15±21.26)mL、输血量为(102.03±8.54)mL,均低于B组,差异有统计学意义(P<0.05)。A组患者的手术时间略长于B组,差异无统计学意义(P>0.05)。A组的术后拔管时间为(4.88±0.26)d、饮食恢复时间为(2.32±0.58)d、住院时间为(6.97±0.97)d,均短于B组,差异有统计学意义(P<0.05)。术前,两组患者的各项肝功能指标比较,差异无统计学意义(P>0.05)。术后1 d,A组患者的ALT、AST水平低于B组,差异有统计学意义(P<0.05)。术后3 d,A组患者的ALT水平低于B组,差异有统计学意义(P<0.05)。A组患者的并发症发生率为6.12%,B组为22.92%,差异有统计学意义(P<0.05)。结论肝癌患者采取LMH治疗的效果优于开腹大范围肝切除术,可优化治疗指标,缩短术后康复时间,且能改善肝功能,减少并发症。

Objective To explore the therapeutic effect of laparoscopic extensive hepatectomy(LMH)and open extensive hepatectomy.Methods A total of 97 patients with liver cancer who were hospitalized from December 2018 to December 2020 were selected as the research subjects.According to the random number table method,49 patients in group A were treated with LMH,and 48 patients in group B were treated with open extensive hepatectomy.Perioperative treatment indexes,liver function indexes and complication rates were compared.Results Of group A,the incision length was(9.08±0.65)cm,and the amount of intraoperative blood loss was(342.15±21.26)mL,and the amount of blood transfusion was(102.03±8.54)mL,which were less than those of group B,with statistically significant differences(P<0.05).The operation time of group A was slightly longer than that of group B,with no statistically significant difference(P>0.05).The postoperative extubation time(4.88±0.26)d,diet recovery time(2.32±0.58)d and hospitalization time(6.97±0.97)d in group A were shorter than those in group B,with statistically significant differences(P<0.05).Before operation,the difference in liver function indexes between the 2 groups was not statistically significant(P>0.05).On postoperative day 1,the levels of ALT and AST in group A were lower than those in group B,with statistically significant differences(P<0.05).At 3 days after operation,the ALT level in group A was lower than that in group B,with a statistically significant difference(P<0.05).The complication rates were 6.12%in group A and 22.92%in group B,with a statistically significant difference(P<0.05).Conclusion The effect of LMH treatment for patients with liver cancer is better than that of open extensive hepatectomy,which can optimize treatment indexes,shorten postoperative recovery time,improve liver function and reduce complications.