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目的:比较解剖性与非解剖性肝切除原发性肝癌的手术效果。方法:采用前瞻性病例对照研究,其中解剖法肝切除53例,非解剖法肝切除59例,比较两组患者的手术时间、术中出血量、术中输血量、术后并发症发生率、谷草转氨酶(AST)、引流量、排气时间、术后住院时间和切缘是否无瘤。结果:两组患者一般情况、脏器功能、肝癌分布、解剖变异和切肝范围均无统计学差异,具有可比性。与非解剖法肝切除组比较,解剖法肝切除组术中出血量、术后并发症发生率、引流量均明显降低(P<0.05),手术时间延长(P<0.05);术后排气时间和术后住院时间两组间差异无统计学意义;两组均可达到切面无瘤的标准。结论:解剖性肝切除具有手术打击小,术中出血少,术后渗出及并发症少等优点,虽然手术时间较长,但仍可作为治疗原发性肝癌的首选手术方式,值得推广。
Objective: To compare the surgical results of anatomical and non-anatomic liver resection of primary liver cancer. Methods: A prospective case-control study was conducted in which 53 cases of hepatectomy under anatomical method and 59 cases of non-anatomic hepatectomy were selected. The operation time, intraoperative blood loss, intraoperative blood loss, postoperative complication rate, Aspartate aminotransferase (AST), drainage, exhaust time, postoperative hospital stay and tumor-free margin. Results: The two groups of patients in general, organ function, distribution of liver cancer, anatomical variation and liver resection range were not statistically different, comparable. Compared with the non-anatomic liver resection group, the amount of bleeding, the incidence of postoperative complications and drainage were significantly decreased (P <0.05) and the operation time was longer (P <0.05) There was no significant difference between the two groups in time and postoperative hospital stay; both groups achieved the tumor-free criteria. Conclusions: Anatomic hepatectomy has the advantages of small surgical hitting, less intraoperative bleeding, less postoperative exudation and less complications. Although the operation time is longer, it is still the first choice for the treatment of primary liver cancer and is worth promoting.