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目的探讨微创腹腔镜与传统开腹肝切除术治疗肝癌的近期效果。方法选取2013年2月至2015年2月间武汉大学人民医院收治的40例肝癌手术患者,采用自愿原则分为研究组与对照组,每组20例。研究组患者采用微创腹腔镜治疗,对照组患者采用传统开腹肝切除术治疗,对比两组患者术中情况、术后恢复情况、手术前后血清指标、1年内生存率和局部复发率及转移率。结果研究组患者手术出血量低于对照组,术后排气时间、下床活动时间、引流管留置时间、进食时间及住院时间均低于对照组,两组比较,差异均有统计学意义(均P<0.05)。研究组患者术后血清白细胞介素-6、降钙素原、人基质金属蛋白酶-13和细胞间黏附分子-1水平均优于对照组,两组比较,差异均有统计学意义(均P<0.05)。2组患者手术时间、1年内生存率、局部复发率及转移率对比,差异均无统计学意义(均P>0.05)。结论微创腹腔镜肝切除术与传统开腹肝切除术后的复发率、转移率与生存率无明显差异,且出血少、恢复快,住院时间短,值得临床推广。
Objective To explore the short-term effect of minimally invasive laparoscopy and conventional open hepatectomy on hepatocellular carcinoma. Methods Forty HCC patients who were admitted to Wuhan University People’s Hospital from February 2013 to February 2015 were divided into study group and control group according to the voluntary principle, with 20 cases in each group. The patients in the study group were treated with minimally invasive laparoscopy. The patients in the control group were treated by conventional open hepatectomy. The intraoperative symptoms, postoperative recovery, preoperative and postoperative serum indexes, the 1-year survival rate and local recurrence rate and metastasis were compared rate. Results The bleeding volume of the study group was lower than that of the control group. The postoperative exhaust time, ambulation time, drainage tube indwelling time, feeding time and hospitalization time were lower than the control group, the difference was statistically significant All P <0.05). The levels of serum interleukin-6, procalcitonin, human matrix metalloproteinase-13 and intercellular adhesion molecule-1 in the study group were better than those in the control group, the differences were statistically significant (P <0.05). There was no significant difference in the operation time, survival rate within 1 year, local recurrence rate and metastasis rate between the two groups (all P> 0.05). Conclusions There is no significant difference between the minimally invasive laparoscopic hepatectomy and conventional open hepatectomy in the recurrence rate, metastasis rate and survival rate, and less bleeding, faster recovery and shorter hospital stay, which deserves clinical promotion.