CAJ | 학술논문

目的：比较解剖性与非解剖性肝切除原发性肝癌的手术效果。方法：采用前瞻性病例对照研究，其中解剖法肝切除53例，非解剖法肝切除59例，比较两组患者的手术时间、术中出血量、术中输血量、术后并发症发生率、谷草转氨酶(AST)、引流量、排气时间、术后住院时间和切缘是否无瘤。结果：两组患者一般情况、脏器功能、肝癌分布、解剖变异和切肝范围均无统计学差异，具有可比性。与非解剖法肝切除组比较，解剖法肝切除组术中出血量、术后并发症发生率、引流量均明显降低(P<0.05)，手术时间延长(P<0.05)；术后排气时间和术后住院时间两组间差异无统计学意义；两组均可达到切面无瘤的标准。结论：解剖性肝切除具有手术打击小，术中出血少，术后渗出及并发症少等优点，虽然手术时间较长，但仍可作为治疗原发性肝癌的首选手术方式，值得推广。
목적：비교해부성여비해부성간절제원발성간암적수술효과。방법：채용전첨성병례대조연구，기중해부법간절제53례，비해부법간절제59례，비교량조환자적수술시간、술중출혈량、술중수혈량、술후병발증발생솔、곡초전안매(AST)、인류량、배기시간、술후주원시간화절연시부무류。결과：량조환자일반정황、장기공능、간암분포、해부변이화절간범위균무통계학차이，구유가비성。여비해부법간절제조비교，해부법간절제조술중출혈량、술후병발증발생솔、인류량균명현강저(P<0.05)，수술시간연장(P<0.05)；술후배기시간화술후주원시간량조간차이무통계학의의；량조균가체도절면무류적표준。결론：해부성간절제구유수술타격소，술중출혈소，술후삼출급병발증소등우점，수연수술시간교장，단잉가작위치료원발성간암적수선수술방식，치득추엄。
Objective To compare the effi cacies of anatomic and nonanatomic hepatectomy for hepatocellu-lar carcinoma of cirrhosis. Methods The clinical data of 112 patients with hepatocellular carcinoma of cirrhosis undergoing hepatectomies were retrospectively analysed. Using a prospective, cohort-controlled design, 53 pa-tients with hepatocellular carcinoma of cirrhosis underwent anatomic hepatectomy and the other 59 patients with hepatolithiasis underwent nonanatomic hepatectomy. The operative time, intraoperative blood loss, incidence of postoperative complications, postoperative aspartate transaminase (AST) level, postoperative drainage volume, time to flatus and length of postoperative hospitalization of the two groups were compared. Results There were no sig-nificant differences in the general condition, organs function, stone distribution,anatomic variation and scope of liver resection between the two groups before operation. The intraoperative blood loss, incidence of postoperative complications, AST level and drainage volume were significantly reduced but the operative time was significantly prolonged in anatomic hepatectomy group compared with nonanatomic hepatectomy group (all P<0.05). No diff er-ences between the two groups were noted with regard to the time span for fl atus and length of postoperative hos-pital. Conclusion Anatomic hepatectomy has the advantages of minimum surgical trauma as well as reduced exu-dation and less complications and reduced the intraoperative blood loss. Although it currently requires longer op-erative time than nonanatomic procedure, its potentiality for improvement is possible. So it deserves to be widely performed.