腹腔镜下肝切除术治疗肝血管瘤临床研究

腹腔镜下肝切除术治疗肝血管瘤临床研究
符开伙;张剑权;蒋明
【期刊名称】《实用肝脏病杂志》
【年(卷),期】2016(19)6
【摘要】目的：探讨全腹腔镜下肿瘤切除术治疗肝脏Ⅰ、Ⅳa、Ⅶ、Ⅷ段血管瘤患者的临床效果。

方法选取我院2012年1月～2013年1月收治的74例肝脏Ⅰ、
Ⅳa、Ⅶ、Ⅷ段血管瘤患者为研究对象，随机分为两组，37例接受常规开腹手术，而另37例行全腹腔镜下肿瘤切除术。

观察两组患者术后疼痛评分、各项临床指标和术后并发症发生情况。

结果腔境组患者胃肠功能恢复时间、进食时间、住院时间和留置导尿管时间分别为（2.6±0.8） d、（2.9±0.8） d、（13.2±1.3） d、（2.9±0.9） d，均明显短于开腹组【分别为（4.28±1.12） d、（4.81±0.75） d、（17.4±2.48） d、（4.5±1.51） d，P<0.05】；腔境组术中出血量为
（110.2±32.4） ml，明显少于开腹组【（155.6±40.3）ml，P<0.05】，腔境组医疗花费为（8437.0±206.7）元，明显高于开腹组【（6399±110.4）元，
P<0.05】；腔境组术后并发症发生率为2.7%，明显低于开腹组的16.2%
（x2=5.045，P=0.028）；随访36个月，腔境组肿瘤复发率为8.1%，与开腹组的2.7%比，差异无统计学意义（x2=1.057，P=0.307）；两组患者术后4 h疼痛评分呈现上升趋势，至术后12 h达到峰值，腔境组术后疼痛评分显著低于开腹组（P＜0.05）。

结论腹腔镜手术治疗肝脏Ⅰ、Ⅳa、Ⅶ、Ⅷ段血管瘤患者的疗效与
开腹手术相似，但具有创伤小、出血量少和术后恢复快等诸多优点，是一种安全的术式。

%Objective To investigate the clinical effect of laparoscopic tumor resection in treatment of patients with hem angioma of liver at I and Ⅳa Ⅶ
and Ⅷ section. Methods 74 patients with hemangioma of liver at I and
Ⅳa,Ⅶ and Ⅷ section were admitted to our hospital between January 2012 and January 2013. They were randomly divided into two groups,and 37 patients were treated with routine open surgery (ROS),while another 37 patients were treated by laparoscopic tumor resection (LTR). Postoperative pain scores,clinical indicators and postoperative complications in the two groups were observed. Results The recovery of gastrointestinal function,feeding,hospitalization and indwelling catheter in patients receiving LTR were (2.6±0.8) d,(2.9±0.8) d,(13.2±1.3) d,(2.9±0.9) d,much shorter than in patients receiving ROS[(4.28±1.12) d,(4.81±0.75)
d,(17.4±2.48) d,(4.5±1.51) d,respective ly,P<0.05];the blood loss during operation in LTR were (110.2±32.4) ml,much lower than in ROS [(155.6±40.3) ml,P<0.05];the medical cost in LTR were (8437.0±206.7) yuan,much higher than in ROS[(6399±110.4) yuan,P<0.05];the postoperative complication rate in LTR was 2.7%, much higher than 16.2% in ROS (x2=5.045,P=0.028);the recurrence rate of tumor in LTR at the end of 36-month followed-up was 8.1%,which was not significantly different with 2.7% in ROS(x2=1.057,P=0.307);postoperative pain scores in the two groups reached peak after 12 h,and the postoperative pain score in LTR was significantly lower than that in ROS (P<0.05). Conclusion Laparoscopic surgery in treatment of patients with hemangioma of liver at special sections has some virtues such as less trauma,less bleeding,fast recovery and less costs.
【总页数】4页(P709-712)
【作者】符开伙;张剑权;蒋明
【作者单位】571700 海南省儋州市海南省西部中心医院普外科;海口市人民医院肝胆外科;571700 海南省儋州市海南省西部中心医院普外科
【正文语种】中文
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