入肝血流不同处理方式对肝癌手术患者的疗效及对其不良反应的影响分析

Effects of Different Treatments of the Hepatic Blood Inflow on Patients Undergoing Liver Cancer Surgery and Their Adverse Reactions

目的研究入肝血流不同处理方式对肝癌手术患者的疗效及对其不良反应等的影响。方法104例肝癌患者需要行手术,根据入肝血流不同处理方式进行分组,其中53例患者采用Glisson鞘外血流阻断为观察组,51例患者采用Pringle全入肝血流阻断为对照组。观察两组患者手术临床指标,术前及术后1 d、3 d、7 d肝功能指标,术后不良反应情况,术后情况,术前及术后生活质量评分。结果两组患者肝血流阻断时间差异无统计学意义(P>0.05),但观察组手术时间、术中出血量、术中输血量、住院天数优于对照组(P<0.05)。术前两组患者肝功能指标对比差异无统计学意义(P>0.05),术后1 d、3 d、7 d观察组谷草转氨酶(aspartate transaminase,AST)、谷丙转氨酶(alanine aminotransferase,ALT)、总胆红素(total bilirubin,TBIL)水平低于对照组(P<0.05),血清白蛋白(albumin,ALB)高于对照组(P<0.05)。观察组不良反应发生率为11.32%,低于对照组(29.41%)(P<0.05)。观察组1年肿瘤累计复发率为16.98%,低于对照组(33.33%)(P<0.05),两组术后1年总生存率、3年总生存率比较差异无统计学意义(P>0.05)。两组术前生活质量评分对比差异无统计学意义(P>0.05),术后两组生活质量评分高于术前,且观察组优于对照组(P<0.05)。结论Glisson鞘外血流阻断法操作简便,安全可行,有利于机体恢复。

Objective To study the effects of different treatments of hepatic blood inflow on patients undergoing liver cancer surgery and on their adverse reactions.Methods A retrospective analysis was carried out on the clinical data of 104 patients underwent liver cancer surgery.According to the different treatment methods of hepatic blood inflow,53 patients treated with Glisson extrathecal blood flow blockade were included in the observation group,and 51 patients treated with Pringle total hepatic blood flow blockade were included in the control group.The clinical indicators,liver function indicators before and 1 d,3 d,7 d after operation,postoperative adverse reactions,postoperative conditions,preoperative and postoperative quality of life scores were observed between the 2 groups.Results There was no significant difference in hepatic blood flow block time between the 2 groups(P>0.05),but the operation time,intraoperative blood loss,intraoperative blood transfusion,and hospital stay in the observation group were better than those in the control group(P<0.05).There was no statistically significant difference in liver function indexes between the 2 groups before operation(P>0.05).Aspartate transaminase(AST),alanine aminotransferase(ALT),total bilirubin(TBIL)in the observation group were lower than the control group 1 d,3 d and 7 d after operation(P<0.05),while the serum albumin(albumin,ALB)was higher than the control group(P<0.05).The adverse reaction rate of the observation group was lower than that of the control group(11.32%vs.29.41%,P<0.05).The 1-year cumulative tumor recurrence rate of the observation group was lower than that of the control group(16.98%vs.33.33%,P<0.05).There was no significant difference in the 1-year overall survival rate and 3-year overall survival rate between the two groups(P>0.05).There was no statistically significant difference in the quality of life scores between the 2 groups before surgery(P>0.05).The quality of life scores of the 2 groups after surgery were higher than those before surgery,and the observation group was better than the control group(P<0.05).Conclusion The Glisson extrathecal blood flow blockade method is easy to operate,safe and feasible,and is beneficial to the recovery of the body.