CAJ | 학술논문

目的：探讨比较解剖式和非解剖式肝切除术治疗原发性肝癌（HCC ）的手术疗效及其影响因素分析。方法将78例HCC患者按照手术方式的不同随机分为解剖式和非解剖式肝切除术组，每组各39例，对比两种手术方式的临床疗效，术中出血量、手术时间、住院时间、术后平均禁食时间、平均腹腔引流时间、并发症发生率及生存率指标，并筛选影响预后的因素。结果术后解剖组和非解剖组的总体有效率和住院时间比较差异无统计学意义（P＞0．05）；但解剖组平均出血量、禁食时间、腹腔引流时间、并发症的发生率均明显低于非解剖组，而手术时间则明显高于非解剖组，差异均有统计学意义（P＜0．05）；解剖组生存率优于非解剖组，且与肿瘤大小、门静脉浸润、切缘和乙肝显著相关（P＜0．05）。结论解剖式肝切除术虽操作复杂，但治疗HCC的临床疗效和安全性均优于非解剖式切除术，且能更好提高术后生存率。
목적：탐토비교해부식화비해부식간절제술치료원발성간암（HCC ）적수술료효급기영향인소분석。방법장78례HCC환자안조수술방식적불동수궤분위해부식화비해부식간절제술조，매조각39례，대비량충수술방식적림상료효，술중출혈량、수술시간、주원시간、술후평균금식시간、평균복강인류시간、병발증발생솔급생존솔지표，병사선영향예후적인소。결과술후해부조화비해부조적총체유효솔화주원시간비교차이무통계학의의（P＞0．05）；단해부조평균출혈량、금식시간、복강인류시간、병발증적발생솔균명현저우비해부조，이수술시간칙명현고우비해부조，차이균유통계학의의（P＜0．05）；해부조생존솔우우비해부조，차여종류대소、문정맥침윤、절연화을간현저상관（P＜0．05）。결론해부식간절제술수조작복잡，단치료HCC적림상료효화안전성균우우비해부식절제술，차능경호제고술후생존솔。
Objective To compare the effects of anatomical and non-anatomical liver resection surgery in pa-tients with hepatocellular carcinoma (HCC) and to analyze the factors influencing prognosis .Methods A total of 78 patients with HCC were divided into anatomical and non-anatomical liver resection group ,with 39 cases in each group .Clinical efficacy ,blood loss ,operative time ,duration of hospitalization ,postoperative mean fasting time ,average peritoneal drainage time ,incidence of complications and indicators of survival rate were compared between the two groups ,and factors influencing prognosis were screened .Results There were no significant differences of clinical ef-ficiency and duration of hospitalization between the two groups (P>0 .05) .The average amount of bleeding ,fasting time ,peritoneal drainage time and incidence of complications in anatomical group were significantly lower than non-anatomical group ,while the operative time was longer(P<0 .05) .Survival rate of anatomical group was higher than non-anatomical group ,which was correlated with tumor size ,portal vein invasion ,surgical margin and hepatitis B(P<0 .05) .Conclusion Although anatomic liver resection operation might be complex ,but its efficacy and safety in the treatment of HCC could be better than non-anatomical resection ,and could improve survival rate .