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目的探讨精准肝切除治疗原发性肝癌的临床疗效。方法 100例原发性肝癌患者均分精准肝切除(A)组和传统肝切除(B)组。A组术前行CT三维重建及计算机辅助方案制定,术中超声精准定位,行半肝入肝血流阻断;B组仅术中采用Pringle法行全肝入肝血流阻断。比较两组临床相关指标。结果与B组比较,A组手术时间长[(174.6±41.9)min vs.(254.8±29.8)min]、肛门排气时间和住院时间短[(83.6±6.5)min vs.(74.6±5.2)min和(17.1±2.3)d vs.(14.3±1.4)d]、术中出血量和腹腔引流量少[(654.2±196.1)ml vs.(487.1±119.4)ml和(784.1±150.3)ml vs.(648.2±114.5)ml]、术后1周ALT峰值和术后并发症发生率低[(495.1±291.1)U/L vs.(356.8±162.6)U/L和26%vs.10%](P<0.05)。结论与传统肝切除方案比较,精准肝切除治疗原发性肝癌安全,效果较好。
Objective To investigate the clinical efficacy of precision hepatectomy in the treatment of primary liver cancer. Methods One hundred patients with primary liver cancer were divided into two groups: group A (precision hepatectomy) and group B (group B). In group A, CT three-dimensional reconstruction and computer-aided planning were performed preoperatively. Ultrasonography was performed intraoperatively and the blood flow was blocked in the hemihepatic hepatic vein. In the group B, only Pringle method was used to block the hepatic blood flow in the whole liver. The two groups of clinically relevant indicators were compared. Results Compared with group B, the operation time in group A was shorter (174.6 ± 41.9 min vs. 254.8 ± 29.8 min), and the time of anal exhaust and hospital stay was shorter (83.6 ± 6.5 min vs 74.6 ± 5.2) min and (17.1 ± 2.3) d vs. (14.3 ± 1.4) d], respectively, with less intraoperative bleeding and less peritoneal drainage [(654.2 ± 196.1) ml vs. (487.1 ± 119.4) ml vs (784.1 ± 150.3) ml vs (648.2 ± 114.5) ml]. The peak ALT and the incidence of postoperative complications at 1 week after surgery were lower (495.1 ± 291.1 U / L vs. 356.8 ± 162.6 U / L and 26% vs. 10% (P <0.05). Conclusion Compared with traditional hepatectomy, accurate hepatectomy for the treatment of primary liver cancer is safe and effective.