摘要
目的:比较间歇性与区域性两种入肝血流阻断方法在大肝癌腹腔镜根治术中的应用效果。方法:选择2019年10月—2022年10月赣州市第五人民医院收治的原发性肝癌患者61例。患者均接受腹腔镜根治术治疗,并根据术中入肝血流阻断方法分为间歇组(n=29)和区域组(n=32)。比较两组手术相关指标、血流动力学、肝功能、并发症发生率。结果:两组手术时间和术后住院时间比较,差异均无统计学意义(P>0.05),区域组术中出血量少于间歇组(P<0.05);两组术前、术毕的平均动脉压、心率比较,差异均无统计学意义(P>0.05);术后3 d,区域组丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、血清总胆红素水平均低于间歇组,白蛋白水平高于间歇组(P<0.05);两组并发症发生率比较,差异均无统计学意义(P>0.05)。结论:在大肝癌腹腔镜根治术中,间歇性与区域性的入肝血流阻断方法均具有较好效果,而后者较前者更有利于减少术中出血,降低肝功能损伤,也不会增加术后并发症风险。
Objective:To compare the application effect of intermittent and regional hepatic blood inflow occlusion method in laparoscopic radical surgery of large hepatic carcinoma.Method:A total of 60 patients with primary hepatic carcinoma treated in the Fifth People's Hospital of Ganzhou from October 2019 to October 2022 were selected.All patients underwent laparoscopic radical surgery and were divided into intermittent group(n=28)and regional group(n=32)according to intraoperative hepatic blood inflow occlusion method.The operation related indexes,hemodynamics,liver function and complication rate were compared between the two groups.Result:There were no significant differences in operation time and postoperative hospital stay between the two groups(P>0.05),and the intraoperative bleeding volume in the regional group was less than that in the intermittent group(P<0.05).There were no significant differences in mean arterial pressure and heart rate between the two groups before and after surgery(P>0.05).3 days after surgery,the levels of alanine aminotransferase,aspartate aminotransferase and serum total bilirubin in regional group were lower than those in intermittent group,and the albumin level in regional group was higher than that in intermittent group(P<0.05).There were no significant differences in the incidences of complications between the two groups(P>0.05).Conclusion:In laparoscopic radical surgery of large hepatic carcinoma,both intermittent and regional hepatic blood inflow occlusion methods have good effects,while the latter is more conducive to reducing intraoperative bleeding,reducing liver function injury,and not increasing the risk of postoperative complications.
作者
王旭升
WANG Xu(The Fifth People's Hospital of Ganzhou,Jiangxi Province,Ganzhou 341000,China)
出处
《中国医学创新》
CAS
2023年第34期41-45,共5页
Medical Innovation of China
关键词
间歇性全入肝血流阻断
区域性入肝血流阻断
原发性肝癌
大肝癌
腹腔镜根治术
肝功能
Intermittent complete hepatic blood inflow occlusion
Regional hepatic blood inflow occlusion
Primary hepatic carcinoma
Large hepatic carcinoma
Laparoscopic radical surgery
Liver function
