三维重建技术联合腹腔镜精准肝切除术治疗原发性肝癌的临床疗效观察

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英文篇名：Observation on the clinical efficacy of three dimensional reconstruction technique combined with laparoscopic precise hepatectomy for primary liver cancer 作者：贾萌 英文作者：JIA Meng;Department of Hepatobiliary Surgery,The First Affiliated Hospital of Zhengzhou University; 关键词：原发性肝癌 ; 三维重建技术 ; 精准肝切除术 ; 腹腔镜 英文关键词：primary liver cancer;;three dimensional reconstructiontechnique;;precise hepatectomy;;laparoscopy 中文刊名：GDWZ 英文刊名：Journal of Hepatobiliary Surgery 机构：郑州大学人民医院肝胆外科; 出版日期：2017-04-30 出版单位：肝胆外科杂志 年：2017 期：v.25 语种：中文; 页：GDWZ201702010 页数：4 CN：02 ISSN：34-1143/R 分类号：40-42+47

摘要

目的探讨三维重建技术联合腹腔镜精准肝切除术治疗原发性肝癌的临床疗效。方法收集2014年2月~2016年2月我院肝胆外科收治的60例原发性肝癌患者为研究对象,随机数字表法均分为对照组及联合组各30例,对照组实施腹腔镜精准肝切除术治疗治疗,联合组实施三维重建技术联合腹腔镜精准肝切除术治疗,观察2组手术基本情况[手术时间、术中出血量、住院时间、肛门排气时间]、肝功能[谷丙转氨酶(ALT)、总胆红素(TBi L)、谷草转氨酶(AST)、白蛋白(ALB)]、并发症及预后随访情况。结果联合组术中出血量较对照组显著少,住院时间、肛门排气时间较对照组显著短(P<0.05);2组手术时间、术前ALT、TBi L、AST、ALB相较无明显差异(P>0.05);术后2组ALT、TBi L、AST较术前明显降低,ALB明显升高,且联合组肝功能各项指标的变化程度较对照组明显(P<0.05);术后联合组并发症总发生率13.33%、术后半年复发转移率3.33%、死亡率3.33%较对照组显著低,差异有统计学意义(P<0.05)。结论三维重建技术联合腹腔镜精准肝切除术治疗原发性肝癌可明显缩短患者康复相关时间,减少术中出血量,降低并发症发生率、复发转移率及死亡率,有推广应用价值。
        Objective To investigate the clinical efficacy of three dimensional reconstruction technique combined with laparoscopic precise hepatectomy for primary liver cancer.Methods A total of 60 patients with primary liver cancer who were admitted to our hospital from February 2014 to February 2016 were enrolled in this study.They were randomly divided into the control group and the combination group by the random number table method,30 cases in each group.The control group were treated with precise laparoscopic hepatectomy,and the combination group were treated with three-dimensional reconstruction technique combined with precise laparoscopic hepatectomy.The basic situation of operation(operation time,bleeding volume,length of hospital stay,anal exhaust time),liver function [alanine aminotransferase(ALT),total bilirubin(TBi L),aspartate aminotransferase(AST),albumin(ALB) ],complications and prognosis were observed.Results The introperative blood loss of the combination group was significantly less than that of the control group,and the length of hospital stay and anal exhaust time was significantly shorter than the control group(P < 0.05).The operation time,preoperative ALT,TBi L,AST and ALB showed no significant differences between the two groups(P > 0.05).After operation,the levels of ALT,TBi L and AST decreased significantly,and ALB increased significantly,and the changes of liver function indexes in the combination group were more significant than those in the control group(P < 0.05).The incidence rate of postoperative complications,recurrence and metastasis rate in six months after operation and the mortality rate in the combination group(13.33%,3.33%,3.33%) were significantly lower than those in the control group(P < 0.05).Conclusion Three dimensional reconstruction technique combined with laparoscopic precise hepatectomy can shorten the rehabilitation time of patients with primary liver cancer,reduce intraoperative blood loss,and reduce the incidence of complications,recurrence rate and mortality.

引文

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