CAJ | 학술논문

目的观察精准肝切除治疗原发性肝癌患者的安全性和有效性.方法 86例原发性肝癌患者按频数匹配原则随机分为两组.常规对照组(n=44)采用常规手术处理方法;精准组(n=42)采用精准肝切除,观察比较两组手术失血量、术后肝功能、住院时间、并发症发生及预后等情况.结果精准组与常规对照组相比,术中出血量少[(320±315)ml比(613±526)ml;P<0.001],术后肝功能恢复快(术后7 d ALT为82.7 U/L比321.7 U/L;P<0.001),并发症发生率低(7.1%比20.5%;P<0.001),住院时间缩短(12.3 d比18.6 d;P<0.001).术后1年肿瘤复发率分别为26.2%(11/42)和38.6%(17/44);术后1年生存率分别为78.6%(33/42)和65.9%(29/44),两组预后比较差异有统计学意义(P=0.010;P=0.018).结论肝切除患者在准确的术前评估后采用精准肝切除,手术打击较小,可以减少术后并发症与住院时间,加速患者的康复.
목적 관찰정준간절제치료원발성간암환자적안전성화유효성.방법 86례원발성간암환자안빈수필배원칙수궤분위량조.상규대조조(n=44)채용상규수술처리방법;정준조(n=42)채용정준간절제,관찰비교량조수술실혈량、술후간공능、주원시간、병발증발생급예후등정황.결과 정준조여상규대조조상비,술중출혈량소[(320±315)ml비(613±526)ml;P<0.001],술후간공능회복쾌(술후7 d ALT위82.7 U/L비321.7 U/L;P<0.001),병발증발생솔저(7.1%비20.5%;P<0.001),주원시간축단(12.3 d비18.6 d;P<0.001).술후1년종류복발솔분별위26.2%(11/42)화38.6%(17/44);술후1년생존솔분별위78.6%(33/42)화65.9%(29/44),량조예후비교차이유통계학의의(P=0.010;P=0.018).결론 간절제환자재준학적술전평고후채용정준간절제,수술타격교소,가이감소술후병발증여주원시간,가속환자적강복.
Objective To evaluate the the safety and efficiency of precise liver resection for patients with primary liver cancer. Methods 86 patients with primary liver cancer were randomized to receive conventional routine hepatectomy (n=44) or the precise liver resection (n=42). Outcomes were compared between the precise hepatectomy group and the routine group, including, the blood loss, operation time, morbidity and mortality. Results There were significant differences in morbidity rates (7.1% vs. 20.5%; P<0.001), the blood loss [(320±315) ml vs. (613±526) ml;P<0.001) , postoperative alanine aminotransferase (ALT) value (in postoperation 7 d, 82.7 U/L vs.321.7 U/L; P<0.001) and length of hospital stay (12.3 d vs. 18.6 d; P<0.001) between precise hepatectomy and routine groups. The 1 year tumor recurrence rate and 1 year survival rate were 26.2%(11/42) and 78.6% (33/42) in precise liver resection group, 38.6% (17/44) and 65.9%(29/44) in routine liver resection group,with significant difference (P=0.010;P=0.018). Conclusion Precise liver resection is safe and effective in the treatment of liver tumor without much injury to patients.