精准肝切除治疗原发性肝癌的临床疗效.pdf

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1、·42·2014年1月第4O卷第1期JiangsuMedJ，January14vo【4oQ!论著精准肝切除治疗原发性肝癌的临床疗效黄海秦锡虎柳咏【摘要】目的探讨精准肝切除治疗原发性肝癌的临床疗效。方法100例原发性肝癌患者均分精准肝切除(A)组和传统肝切除(B)组。A组术前行CT三维重建及计算机辅助方案制定，术中超声精准定位，行半肝人肝血流阻断；B组仅术中采用Pringle法行全肝入肝血流阻断。比较两组临床相关指标。结果与B组比较，A组手术时间长[(174．6±41．9)minvs．(254．8±29．8)mini、肛门排

2、气时间和住院时间短E(83．6±6．5)minv&(74．6±5．2)min和(17．1+-2．3)dvs．(14．3±1_4)d__、术中出血量和腹腔引流量少[(654．2±196．1)mlvs．(487．1±119．4)ml和(784．1±150．3)mlvs．(648．2±114．5)m1]、术后1周AL『r峰值和术后并发症发生率低[(495．1±291．1)U／Lvs．(356．8±162．6)U／L和26％vs．10](P<0．05)。结论与传统肝切除方案比较，精准肝切除治疗原发性肝癌安全，效果较好。【关键词】原

3、发性肝癌；精准肝切除【中图分类号】R657【文献标识码】A【文章编号10253—3685(2014)01—0042—03ClinicalefficacyofprecisehepatectomyinpatientswithprimaryhepaticcarcinomaHUANGHal，QINGXJhu，LIUYong．DepartmentofGeneralSurgery，AffiliatedChangzhouTCMHospital，NaniingUniversityofChineseMedicine，Changzhou213

4、000，CHINA[Abstract]0bjectiveToexploretheclinicalefficacyofprecisehepatectomyinpatientswithprimaryhepaticcarcinoma(PHC)．MethodsOnehundredpatientswithPHCwereequallydividedintogroupsofA(treatedwithprecisehepatectomy)andB(treatedwithconventionalhepatectomy)．CT3-diment

5、ionalreconstructionandcomputer-assistedplanbeforeoperationwereconductedingroupA，inwhichpreciselyultrasoniclocalizationandhemihepaticvascularocclusionwerecarriedoutduringoperation．TotalhepaticvascularocclusionwasconductedbyPringlewayingroupBClinicallyrelevantindica

6、torsintwogroupswereanalyzed．ResultsComparedwithgroupB，operativetimewaslongeringroupAE(174．6±41．9)minvs．(254．84_-29．8)mini，thetimeofanusexhaustingandhospita1．staywereshorteringroupAI(83．6±6．5)rainvs．(74．6±5．2)minand(17．1±2．3)dvs．(14．3+-1．4)d]，bloodlossandabdominald

7、rainageduringoperationwerelessingroupA[(654．2±196．1)mlvs．(487．1±l19．4)nlland(784．1±150．3)mlvs．(648．2±114．5)mll，peakofALTonthe7thdayandincidencerateofcomplicationafteroperationwereloweringroupAI(495．1±291．1)U／Lvs．(356．8+-162．6)U／Land26vs．10)](P<0．05)．ConclusionPrec

8、isehepatectomyissaferandmoreeffectivethanconventionalhepatectomyinthetreatmentofPHC[Keywords]Primaryhepaticcarcinoma；Precisehepatectomyl-，iangsuMedJ，Jan