腹腔镜手术切除与腹腔镜微波消融治疗肝血管瘤的疗效比较

肝脏 ›› 2021, Vol. 26 ›› Issue (11): 1283-1286.

腹腔镜手术切除与腹腔镜微波消融治疗肝血管瘤的疗效比较

吕超, 李恒平, 丁正华, 孔雕雕

441000 湖北襄阳锦州医科大学湖北医药学院研究生培养基地(吕超);湖北医药学院附属襄阳市第一人民医院普通外科(李恒平,丁正华,孔雕雕)

收稿日期:2020-12-31 出版日期:2021-11-30 发布日期:2021-12-24
通讯作者: 李恒平,Email:Lhplyl@163.com

Comparison of laparoscopic resection and laparoscopic microwave ablation in the treatment of hepatic hemangioma

LV Chao¹, LI Heng-ping², DING Zheng-hua², KONG Diao-diao²

1. Postgraduate Training Basement of Jinzhou Medicical University,Hubei University of Medicine, Xiangyang 441000, China;
2. Department of General Surgery, Xiang Yang NO.1 People's Hospital, Affiliated Hospital of Hubei University of Medicne, Hu'bei 441000, China

Received:2020-12-31 Online:2021-11-30 Published:2021-12-24
Contact: LI Heng-ping,Email:Lhplyl@163.com

摘要/Abstract

摘要： 目的比较腹腔镜手术切除术与腹腔镜微波消融术这两种术式治疗肝血管瘤的疗效。方法回顾分析自2016年6月至2019年6月湖北医药学院附属襄阳市第一人民医院肝血管瘤患者46例病例资料,按术式分为腹腔镜手术切除术组(A组)和腹腔镜微波消融术组(B组),A组18例,B组28例。从手术时长、术中出血量、住院时间、术后肝功能恢复等方面比较A组和B组对肝血管瘤的疗效。结果与A组相比,B组在缩短手术时长(t=2.797,P=0.008)、降低出血量(t=3.253,P=0.005)、减少住院时间(t=2.065,P=0.045)方面有明显优势。术后第1天 ALT、AST 水平B组高于A组,差异有统计学意义(P<0.05)。术后第3天ALT、AST 水平,术后第1天及第3天总胆红素、直接胆红素、间接胆红素水平,术后并发症发生率,肿瘤复发率,两组差异无统计学意义(P>0.05)。结论腹腔镜微波消融术安全可行,疗效明确,值得临床推广。

关键词: 肝血管瘤, 腹腔镜, 微波消融, 疗效

Abstract: Objective To compare the efficacy of laparoscopic resection and laparoscopic microwave ablation in the treatment of hepatic hemangioma. Methods The clinical data of 46 patients with hepatic hemangioma in our hospital from June 2016 to June 2019 were retrospectively analyzed. They were divided into laparoscopic surgery group (group A) and laparoscopic microwave ablation group (group B), with 18 cases in group A and 28 cases in group B. The therapeutic effects of group A and group B on hepatic hemangioma were compared in terms of operation time, intraoperative blood loss, hospital stay and postoperative liver function recovery. Results Compared with group A, group B had obvious advantages in shortening operation time (t=2.797, P=0.008), reducing blood loss (t=3.253, P=0.005) and reducing hospital stay (t=2.065, P=0.045). On the first day after operation, ALT and AST levels in group B were higher than those in group A (P<0.05). The levels of ALT and AST on the third day after operation, the levels of total bilirubin, direct bilirubin and indirect bilirubin on the first and third days after operation, the incidence of postoperative complications and tumor recurrence rate between the two groups were not statistically significant (P>0.05). Conclusion Laparoscopic microwave ablation is safe, feasible and effective, which is worthy of clinical promotion.

Key words: Hepatic hemangioma, Laparoscopy, Microwave ablation, Curative effect

吕超, 李恒平, 丁正华, 孔雕雕. 腹腔镜手术切除与腹腔镜微波消融治疗肝血管瘤的疗效比较[J]. 肝脏, 2021, 26(11): 1283-1286.

LV Chao, LI Heng-ping, DING Zheng-hua, KONG Diao-diao. Comparison of laparoscopic resection and laparoscopic microwave ablation in the treatment of hepatic hemangioma[J]. Chinese Hepatolgy, 2021, 26(11): 1283-1286.

参考文献

[1] European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines on the management of benign liver tumours. J Hepatol, 2016, 65: 386-398.
[2] Mocchegiani F, Vincenzi P, Coletta M, et al. Prevalence and clinical outcome of hepatic haemangioma with specific reference to the risk of rupture: A large retrospective cross-sectional study. Dig Liver Dis, 2016, 48: 309-314.
[3] Zhao W, Guo X, Dong J. Spontaneous rupture of hepatic hemangioma: a case report and literature review. Int J Clin Exp Pathol, 2015, 8: 13426-13428.
[4] 陈孝平,夏锋,李雪松. 肝血管瘤诊断和治疗多学科专家共识(2019版). 临床肝胆病杂志, 2019, 35: 1928-1932.
[5] Corigliano N, Mercantini P, Amodio PM, et al. Hemoperitoneum from a Spontaneous Rupture of a Giant Hemangioma of the Liver : Report of a Case. Surg Today, 2003, 33: 459-463.
[6] 周爱华. 100例肝血管瘤的临床治疗分析. 现代诊断与治疗, 2016, 27: 4729-4731.
[7] 马亮亮,邵志江,李灿明,等. 肝血管瘤的治疗进展. 黑龙江医学,2020, 05: 718-720.
[8] Srinivasa S, Lee WG, Aldameh A, et al. Spontaneous hepatic haemorrhage: a review of pathogenesis, aetiology and treatment. HPB, 2015, 17: 872-880.
[9] Chang A, Ruch B, Khan A, et al. Giant liver hemangiomas: a plea for early surgical referral and resection. Case Rep Surg, 2020, 2020: 5923787.
[10] Belghiti J, Cauchy F, Paradis V, et al. Diagnosis and management of solid benign liver lesions. Nat Rev Gastroenterol Hepatol, 2014, 11: 737-49.
[11] 荚卫东,刘文斌. 《肝血管瘤诊断和治疗多学科专家共识(2019版)》解读. 临床外科杂志, 2020, 28: 19-22.
[12] 张树彬,王丽丽,冯峰,等. 腹腔镜肝血管瘤剥除术的临床应用. 腹部外科, 2020, 33: 136-139.
[13] 侯鹏高. 肝血管瘤外科治疗进展. 齐齐哈尔医学院学报, 2014, 35: 3206-3207.
[14] 蔡雄,唐勇,孙释然,等. 腹腔镜直视下超声引导结合第一肝门阻断微波消融治疗肝血管瘤的体会(附56例报道). 华中科技大学学报(医学版), 2018, 47: 707-710.
[15] 刘磊. 腹腔镜下微波消融治疗肝血管瘤的效果研究. 中国疗养医学, 2018, 27: 260-261.
[16] 王瑞官,郑方,李为民,等. 腹腔镜下微波消融治疗特殊肝段大血管瘤或肝巨大血管瘤临床效果观察. 临床军医杂志, 2019, 47: 1287-1289.