解剖性肝叶切除术治疗原发性肝癌的临床效果及对患者肝功能和预后的影响

Clinical Effect of Anatomical Hepatectomy in the Treatment of Primary Liver Cancer and Its Influence on Liver Function and Prognosis of Patients

目的:探讨研究解剖性肝叶切除术治疗原发性肝癌的临床效果及对患者肝功能和预后的影响。方法:将2019年7月—2021年7月大冶市人民医院收治的原发性肝癌患者中随机抽出76例作为观察对象,根据治疗方法选择的不同分为两组,其中38例采取解剖性肝叶切除术纳入观察组,38例采取非解剖性肝叶切除术纳入对照组,比较两组临床效果、肝功能和预后情况。结果:观察组手术时间较对照组长,术中出血量、术中输血量均较对照组低,住院时间较对照组短,差异均有统计学意义(P<0.05)。术后7 d,两组丙氨酸氨基转移酶(alanine aminotransferase,ALT)、总胆红素(total bilirubin,TBIL)、天冬氨酸氨基转移酶(alanine aminotransferase,AST)较术前均升高,但观察组均低于对照组,差异均有统计学意义(P<0.05)。观察组并发症发生率为10.53%,低于对照组的31.58%,差异有统计学意义(P<0.05);观察组术后1年复发转移率为10.53%,低于对照组的31.58%,1年内生存率为84.21%,高于对照组的52.63%,差异均有统计学意义(P<0.05)。结论:解剖性肝叶切除术治疗原发性肝癌患者的临床效果更显著,不仅可减轻肝功能受损程度,还能提高手术效果,降低并发症发生率,且预后良好,改善1年内生存率和复发转移率。

Objective:To investigate the clinical effect of anatomical hepatectomy in the treatment of primary liver cancer and its influence on liver function and prognosis of patients.Method:A total of 76 patients with primary liver cancer who admitted to Daye City People's Hospital from July 2019 to July 2021 were randomly selected as observation objects,and divided into two groups according to different treatment methods.Among them,38 patients were included in the observation group by anatomical hepatectomy,and 38 patients were included in the control group by non-anatomical hepatectomy.The clinical effects,liver function and prognosis of the two groups were compared.Result:The operation time of the observation group was longer than that of the control group,and the intraoperative blood loss,intraoperative blood transfusion volume were lower than those of the control group,and hospital stay was shorter than that of the control group,the differences were statistically significant(P<0.05).At 7 d after operation,the alanine aminotransferase(ALT),total bilirubin(TBIL),aspartate aminotransferase(AST)in two groups were higher than those before operation,but the observation group were lower than the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 10.53%,which was lower than 31.58%in the control group,the difference was statistically significant(P<0.05).The recurrence and metastasis rate at 1 year after operation in the observation group was 10.53%,which was lower than 31.58%in the control group,the 1-year survival rate was 84.21%,which was higher than 52.63%in the control group,the differences were statistically significant(P<0.05).Conclusion:Anatomical hepatectomy has a more significant clinical effect in the treatment of patients with primary liver cancer,it can not only reduce the degree of liver function damage,but also improve the surgical effect and reduce the incidence of complications,the prognosis is relatively good,improve the 1-year survival rate and recurrence and metastasis rate.