专题研究(Monographic Study)

实时超声导航下解剖性肝段切除在原发性肝癌治疗中的应用及疗效分析

Published at: 2017年第26卷第1期

周超毅 1 , 马金良 1 , 荚卫东 1 , 余继海 1 , 张传海 1 , 刘文斌 1 , 李国芹 1
1 安徽医科大学附属省立医院 肝脏外科/肝胆胰外科安徽省重点实验室,安徽 合肥 230001
通讯作者 金良 马 Email: Majlwq@163.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2017.01.002
基金:
安徽省自然科学基金资助项目 1608085MH198

摘要

目的:探讨原发性肝细胞癌(肝癌)治疗中应用实时超声导航的解剖性肝段切除的疗效。方法:回顾2014年6月—2015年6月安徽医科大学附属安徽省立医院30例行实时超声导航下解剖性肝段切除的肝癌患者(观察组)与30例行非解剖性肝段切除的肝癌患者(对照组)临床资料,比较两组患者相关临床指标。结果:两组患者术前一般资料具有可比性。与对照组比较,观察组手术时间延长(153.5 min vs. 128.5 min,P<0.05),术中出血量无统计学差异(175.0 mL vs. 200.00 mL,P>0.05),但术中输血率降低(10.0% vs. 36.7%,P<0.05)、肝门阻断率降低(16.7% vs. 40.0%,P<0.05);两组并发症发生率无统计学差异(13.3% vs. 33.3%,P>0.05);观察组的1年复发率低于对照组(16.7% vs. 43.3%,P<0.05),1年存活率高于对照组(80.0% vs. 53.3%,P<0.05)。结论:实时超声导航下解剖性肝段切除的应用对减少肝癌患者术后肿瘤的复发、改善预后有着积极的作用。


Application and efficacy of anatomic segmental hepatic resection under real-time ultrasound navigation in treatment of hepatocellular carcinoma

Abstract

Objective: To determine the efficacy of anatomic segmental hepatic resection under real-time ultrasound navigation in treatment of hepatocellular carcinoma (HCC). Methods: The clinical data of 30 HCC patients undergoing anatomic segmental hepatic resection under real-time ultrasound navigation (observation group) and 30 HCC patients who were subjected to non-anatomic liver resection (control group) from June 2014 to June 2015 in Anhui Provincial Hospital of Anhui Medical University were reviewed. The main clinical variables between the two groups of patients were compared. Results: The preoperative data between the two groups of patients were comparable. In observation group versus control group, the operative time was prolonged (153.5 min vs. 128.5 min, P<0.05), and the intraoperative blood loss showed no significant difference (175.0 mL vs. 200.00 mL, P>0.05), but the intraoperative blood transfusion rate (10.0% vs. 36.7%, P<0.05) and hepatic portal occlusion rate (16.7% vs. 40.0%, P<0.05) were significantly reduced. There was no significant difference in incidence of postoperative complications between the two groups (13.3% vs. 33.3%, P>0.05). In observation group, the 1-year recurrence rate was significantly lower than that in control group (16.7% vs. 43.3%, P<0.05), while 1-year survival rate was significantly higher than that in control group (80.0% vs. 53.3%, P<0.05). Conclusion: Application of anatomic segmental hepatic resection under real-time ultrasound navigation has a beneficial effect on reducing postoperative recurrence and improving prognosis in HCC patients.


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引用

引用本文: 超毅 周, 金良 马, 卫东 荚, 继海 余, 传海 张, 文斌 刘, 国芹 李. 实时超声导航下解剖性肝段切除在原发性肝癌治疗中的应用及疗效分析[J]. 中国普通外科杂志, 2017, 26(1): 6-12.
Cite this article as: ZHOU Chaoyi, MA Jinliang, JIA Weidong, YU Jihai, ZHANG Chuanhai, LIU Wenbin, LI Guoqin . Application and efficacy of anatomic segmental hepatic resection under real-time ultrasound navigation in treatment of hepatocellular carcinoma [J]. Chin J Gen Surg, 2017, 26(1): 6-12.