程序化腹腔镜肝左外叶切除术与开腹肝左外叶切除术临床对比研究

发布时间：2018-08-08 11:10

【摘要】：目的比较程序化腹腔镜肝左外叶切除术(programmed laparoscopic left lateral segment liver resection, LLLR)与开腹肝左外叶切除术(open left lateral segment liver resection,OLLR)治疗肝左外叶肝癌的疗效。方法回顾性分析我院2011年10月～2014年12月其中30例程序化腹腔镜肝左外叶切除术与30例开腹肝左外叶切除术治疗肝左外叶肝癌的两组临床资料,简单介绍程序化腹腔镜肝左外叶切除术方式及术中相关注意事项。比较两组的手术时间、术中失血量、术后住院时间、术后拔管时间、术后使用镇痛药物次数、胃肠功能恢复时间、术前及术后第1天、第3天的TBiL、白蛋白、AST、ALT情况。结果两组患者均顺利完成手术,程序化腹腔镜组无中转开腹,程序化腹腔镜组与开腹组数据比较手术时间、术前白蛋白、ALT、AST,术前和术后胆红素比较均无统计学差异(P0.05)。术中出血量、术后住院时间、术后拔管时间、术后使用镇痛药物次数、胃肠功能恢复时间、术后白蛋白、丙氨酸氨基转移酶ALT、冬氨酸氨基转移酶AST恢复情况均有统计学差异(P0.05)。结论程序化腹腔镜肝左外叶切除术具有简便性、安全性、可行性,较开腹肝左外叶切除术充分发挥了腹腔镜技术的创伤小、恢复快、总体疗效显著等微创优势。
[Abstract]:Objective to compare the efficacy of laparoscopic left lateral lobectomy (programmed laparoscopic left lateral segment liver resection, LLLR) and open left lateral lobectomy (open left lateral segment liver LLLR) in the treatment of left lateral lobe liver cancer (LLHC). Methods from October 2011 to December 2014, the clinical data of 30 cases of laparoscopic left lateral lobectomy and 30 cases of open left lateral lobectomy were retrospectively analyzed. This paper briefly introduces the procedure of laparoscopic left lateral hepatic lobectomy and the relevant points for attention during the operation. The time of operation, the amount of blood lost during operation, the time of postoperative hospitalization, the time of extubation, the times of postoperative analgesic use, the time of recovery of gastrointestinal function, the TBiL and albumin ASTALT before and after operation were compared between the two groups. Results the operation was completed successfully in the two groups. There was no conversion to open surgery in the programmed laparoscopic group. The operation time was compared between the programmed laparoscopic group and the open group. There was no significant difference between the preoperative and postoperative bilirubin levels (P0.05). There were significant differences in intraoperative bleeding, postoperative hospitalization time, postoperative extubation time, postoperative analgesic times, recovery time of gastrointestinal function, postoperative albumin, alanine aminotransferase (alt), aspartate aminotransferase (AST) recovery (P0.05). Conclusion the procedure of laparoscopic left lateral lobectomy is simple, safe and feasible. It has the advantages of less trauma, faster recovery and better overall curative effect than laparoscopic left lateral lobectomy.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.3

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