CAJ | 학술논문

目的：探讨肝炎对结直肠癌肝转移(CRLM)患者外科治疗及预后的影响。方法回顾性分析2007年11月至2013年1月，于北京大学肿瘤医院肝胆胰外一科行手术治疗的175例CRLM患者的临床资料，根据是否合并肝炎，分为合并肝炎组(16例)和未合并肝炎组(159例)比较两组患者围手术期肝功能、手术方式及预后。结果除血小板水平合并肝炎组明显低于未合并肝炎组外(P<0.05)，其他肝功能指标(血清白蛋白、总胆红素及凝血酶原时间)两组差异均无统计学意义(均P>0.05)。两组患者中行大范围肝转移灶切除术的比例分别为37.5%(6/16)和22.0%(35/159)，差异无统计学意义(P>0.05)。手术时间、术中出血量、术后胆漏发生率及术后引流量等围手术期指标两组差异亦无统计学意义(均P>0.05)。两组患者术后中位总生存时间分别为46月和33月，中位无瘤生存时间分别为8月和10月，差异均无统计学意义(均P>0.05)。结论合并肝炎的CRLM患者肝储备功能良好，可以安全地进行大范围肝切除，不会影响生存。
목적：탐토간염대결직장암간전이(CRLM)환자외과치료급예후적영향。방법회고성분석2007년11월지2013년1월，우북경대학종류의원간담이외일과행수술치료적175례CRLM환자적림상자료，근거시부합병간염，분위합병간염조(16례)화미합병간염조(159례)비교량조환자위수술기간공능、수술방식급예후。결과제혈소판수평합병간염조명현저우미합병간염조외(P<0.05)，기타간공능지표(혈청백단백、총담홍소급응혈매원시간)량조차이균무통계학의의(균P>0.05)。량조환자중행대범위간전이조절제술적비례분별위37.5%(6/16)화22.0%(35/159)，차이무통계학의의(P>0.05)。수술시간、술중출혈량、술후담루발생솔급술후인류량등위수술기지표량조차이역무통계학의의(균P>0.05)。량조환자술후중위총생존시간분별위46월화33월，중위무류생존시간분별위8월화10월，차이균무통계학의의(균P>0.05)。결론합병간염적CRLM환자간저비공능량호，가이안전지진행대범위간절제，불회영향생존。
Objcetive To evaluate the effect of hepatitis on surgical treatment and prognosis of colorectal liver metastasis(CRLM). Methods A retrospective study of medical records of all the patients undergoing operation with colorectal liver metastasis in Peking University Hepatobiliary pancreatic Surgery Ward I from November 2007 to January 2013 was conducted. A total of 175 patients were eligible and divided into two groups: with hepatitis (n=16) or without hepatitis (n=159). Results Preoperative liver function was similar in these two groups. There were no significant differences in preoperative serum albumin, total bilirubin and prothrombin time between two groups (all P>0.05), except for lower blood platelet in hepatitis group after operation. Major hepatectomy was performed in 37.5%(6/16) and 22.0%(15/159) of two groups respectively (P>0.05). There were also no significant differences in operation time, blood loss, surgical complications and drainage volume (all P>0.05). The median overall survival time was 46 months in hepatitis group and 33 months in non-hepatitis group, and the median disease free time was 8 months in hepatitis group and 10 months in non-hepatitis group (all P>0.05). Conclusion CRLM patients concomitant with hepatitis have adequate liver reserve function for major hepatic resection and have similar prognosis of patients without hepatitis.