摘要
目的探讨Glisson鞘外血流阻断法在原发性肝癌切除术中的应用价值。方法选取余姚市人民医院在2019年1月至2020年1月收治的原发性肝癌患者74例为研究对象,采用随机数字表法分为两组,每组37例。对照组切除术中选用Pringle全入肝血流阻断法,观察组切除术中选用Glisson鞘外血流阻断法,观察两组相关手术指标及患者术后肝功能、肠胃功能恢复和并发症发生情况等。结果观察组阻断时间为(25.10±5.19)min,术后住院时间为(12.45±1.10)d,均显著短于对照组的(30.65±8.54)min、(14.85±1.28)d(t=3.378、8.650,均P<0.05),患者术中出血量为(490.36±120.19)mL,显著少于对照组的(655.58±152.24)mL(t=5.181,P<0.05),术中输血率为21.62%(8/37),显著低于对照组的45.95%(17/37)(χ^(2)=4.893,P<0.05)。观察组术后1 d、3 d、7 d的天门冬氨酸氨基转移酶水平分别为(240.36±60.52)U/L、(145.69±42.18)U/L、(60.13±12.58)U/L,均显著低于对照组的(350.21±60.16)U/L、(212.53±40.21)U/L、(103.65±20.54)U/L(t=7.930、6.977、10.991,均P<0.05);观察组术后1 d、7 d的丙氨酸氨基转移酶水平分别为(228.52±65.28)U/L、(44.26±12.85)U/L,均显著低于对照组的(350.16±68.58)U/L、(466.36±40.29)U/L(t=7.815、3.179,均P<0.05);观察组术后1 d、7 d的总胆红素分别为(28.58±5.24)μmol/L、(20.30±5.10)μmol/L,均显著短于对照组的(43.32±10.26)μmol/L、(26.08±5.68)μmol/L(t=7.783、4.606,均P<0.05),术后1 d的白蛋白水平为(34.65±2.42)g/L,显著低于对照组的(31.12±2.23)g/L(t=6.525,均P<0.05);观察组术后肠鸣音恢复及肛门首次排气、排便时间分别为(14.28±2.10)h、(29.21±5.10)h、(54.20±5.69)h,均显著短于对照组的(16.65±2.16)h、(33.25±5.47)h、(59.85±5.87)h(t=4.783、3.286、4.204,均P<0.05)。观察组术后并发症总发生率为13.51%(5/37),显著低于对照组的35.14%(13/37)(χ^(2)=4.698,P<0.05)。结论Glisson鞘外血流阻断法应用于原发性肝癌切除术中,在出血控制、术后并发�
Objective To investigate the application value of extrathecal Glisson blood flow occlusion in the resection of primary liver cancer.Methods 74 patients with primary liver cancer who received treatment in Yuyao People's Hospital from January 2019 to January 2020 were included in this study.They were randomly assigned to undergo resection of the primary liver cancer with either extracorporeal Pringle maneuver(control group,n=37)or extrathecal Glisson maneuver(observation group,n=37).Surgery-related indexes,postoperative liver function and gastrointestinal function recovery,and complications were monitored in each group.Results Blood flow occlusion time and hospital length of stay in the observation group were(25.10±5.19)minutes and(12.45±1.10)days,which were significantly shorter than those in the control group[(30.65±8.54)minutes,(14.85±1.28)days,t=3.378,8.650,both P<0.05].Volume of blood loss in the observation group was significantly less than that in the control group[(490.36±120.19)mL vs.(655.58±152.24)mL,t=5.181,P<0.05].Intraoperative blood transfusion rate in the observation group was significantly lower than that in the control group[21.62%(8/37)vs.45.95%(17/37),χ^(2)=4.893,P<0.05].At 1,3 and 7 days after surgery,aspartate aminotransferase level in the observation group was(240.36±60.52)U/L,(145.69±42.18)U/L and(60.13±12.58)U/L,respectively,which was significantly lower than that in the control group[(350.21±60.16)U/L,(212.53±40.21)U/L,(103.65±20.54)U/L,t=7.930,6.977 and 10.991,all P<0.05].At 1 and 7 days after surgery,alanine aminotransferase level in the observation group was(228.52±65.28)U/L and(44.26±12.85)U/L,respectively,which was significantly lower than that in the control group[(350.16±68.58)U/L,(466.36±40.29)U/L,t=7.815 and 3.179,both P<0.05].At 1 and 7 days after surgery,total bilirubin level in the observation group was(28.58±5.24)μmol/L and(20.30±5.10)μmol/L,which was significantly lower than that in the control group[(43.32±10.26)μmol/L,(26.08±5.68)μmol/L,t=7.783,4.606
作者
姚平刚
沈丹
周建春
Yao Pinggang;Shen Dan;Zhou Jianchun(Department of Hepatobiliary and Pancreatic Surgery,Yuyao People's Hospital,Yuyao 315400,Zhejiang Province,China)
出处
《中国基层医药》
CAS
2021年第10期1506-1510,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省余姚市科技计划项目(2019QB12)。
关键词
肝肿瘤
癌
肝切除术
肝功能试验
康复
Liver neoplasms
Carcinoma
Hepatectomy
Liver function tests
Rehabilitation
