肝巨大血管瘤的外科手术治疗
发布时间：2018-11-19 08:32
【摘要】：目的探讨肝切除术与包膜外剥脱术在肝巨大血管瘤切除术中的应用价值,为肝巨大血管瘤的外科手术治疗提供指导。方法本研究回顾性分析2010年6月到2015年6月宁夏自治区人民医院总院和宁夏医科大学附属医院肝胆外科74例肝巨大血管瘤患者的病历资料。其中行肝切除术37例(肝切组),行包膜外剥脱术37例(剥脱组)。比较两组患者术前一般情况,术中手术时间(h)、术中出血量(ml)、术中输血量(ml)、肝血流阻断时间(min)、住院天数(d)等情况。术后主要观察两组患者术后胸腔积液、胆漏、腹腔出血等并发症发生情况。术后随访患者症状改善及血管瘤复发情况。结果剥脱组患者的手术时间[(2.38±0.93)h)]、术中出血量[(889.19±756.37)ml]、术中输血量[(723.78±801.14)ml]、肝血流阻断时间[(22.48±10.87)min]、住院天数[(14.84±3.24)d]均低于肝切组手术时间[(3.26±1.16)h)]、术中出血量[(1551.35±1755.88)ml]、术中输血量[(1693.24±2117.72)ml]、肝血流阻断时间[(26.84±17.30)min]、住院时间[(16.19±5.01)d],差异均有统计学意义(P0.05)。剥脱组胸腔积液发生率低于肝切组,差异有统计学意义(P0.05)。两组患者在胆漏、腹腔出血、患者死亡等并发症方面比较无统计学意义(P0.05)。术后随访死亡率、症状改善、血管瘤复发等无统计学意义。结论肝切除术和包膜外剥脱术都是治疗肝巨大血管瘤的有效术式。肝巨大血管瘤包膜外剥脱术在手术时间、术中出血量、术中输血量、肝血流阻断时间及住院天数方面明显优于肝切组,该术式术后并发症发生率低。肝巨大血管瘤包膜外剥脱术是一种更为安全、简便、高效的术式,值得在临床工作中推广应用。
[Abstract]:Objective to evaluate the value of hepatectomy and extracapsular excision in the resection of giant hepatic hemangioma and to provide guidance for the surgical treatment of hepatic giant hemangioma. Methods from June 2010 to June 2015, the medical records of 74 patients with giant hepatic hemangioma in the General Hospital of the people's Hospital of Ningxia Autonomous region and the affiliated Hospital of Ningxia Medical University were retrospectively analyzed. Among them, 37 cases were treated with hepatectomy (hepatectomy group) and 37 cases with exfoliation of envelope (exfoliation group). The average preoperative condition, intraoperative time, (h), intraoperative blood loss, (ml), blood transfusion, (ml), hepatic blood flow occlusion time, (min), hospitalization time and (d) were compared between the two groups. Postoperative complications such as pleural effusion, bile leakage and abdominal hemorrhage were observed. Symptom improvement and recurrence of hemangioma were followed up. Results in the exfoliation group, the operative time [(2.38 卤0.93) h)], intraoperative blood loss (889.19 卤756.37) ml], intraoperative blood transfusion (723.78 卤801.14) ml), hepatic blood flow occlusion time (22.48 卤10.87) min) were measured. The days of hospitalization [(14.84 卤3.24) d] were lower than those in the hepatectomy group [(3.26 卤1.16) h), (1551.35 卤1755.88) ml, (1693.24 卤2117.72) ml]. Hepatic blood flow occlusion time [(26.84 卤17.30) min] and hospitalization time [(16.19 卤5.01) d] were significantly different (P0.05). The incidence of pleural effusion in exfoliation group was lower than that in hepatectomy group (P0.05). There was no significant difference between the two groups in biliary leakage, abdominal hemorrhage, death and other complications (P0.05). There was no significant difference in postoperative mortality, improvement of symptoms and recurrence of hemangioma. Conclusion hepatectomy and extracapsular exfoliation are effective methods for the treatment of giant hepatic hemangioma. Extracapsulation of giant hepatic hemangioma was significantly better than that of hepatectomy in terms of operation time, intraoperative blood loss, intraoperative blood transfusion, hepatic blood flow occlusion time and hospitalization days, and the incidence of postoperative complications was lower. Extracapsular exfoliation of giant hemangioma of liver is a more safe, simple and efficient procedure, which is worth popularizing in clinical work.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.7
，
本文编号：2341719
[Abstract]:Objective to evaluate the value of hepatectomy and extracapsular excision in the resection of giant hepatic hemangioma and to provide guidance for the surgical treatment of hepatic giant hemangioma. Methods from June 2010 to June 2015, the medical records of 74 patients with giant hepatic hemangioma in the General Hospital of the people's Hospital of Ningxia Autonomous region and the affiliated Hospital of Ningxia Medical University were retrospectively analyzed. Among them, 37 cases were treated with hepatectomy (hepatectomy group) and 37 cases with exfoliation of envelope (exfoliation group). The average preoperative condition, intraoperative time, (h), intraoperative blood loss, (ml), blood transfusion, (ml), hepatic blood flow occlusion time, (min), hospitalization time and (d) were compared between the two groups. Postoperative complications such as pleural effusion, bile leakage and abdominal hemorrhage were observed. Symptom improvement and recurrence of hemangioma were followed up. Results in the exfoliation group, the operative time [(2.38 卤0.93) h)], intraoperative blood loss (889.19 卤756.37) ml], intraoperative blood transfusion (723.78 卤801.14) ml), hepatic blood flow occlusion time (22.48 卤10.87) min) were measured. The days of hospitalization [(14.84 卤3.24) d] were lower than those in the hepatectomy group [(3.26 卤1.16) h), (1551.35 卤1755.88) ml, (1693.24 卤2117.72) ml]. Hepatic blood flow occlusion time [(26.84 卤17.30) min] and hospitalization time [(16.19 卤5.01) d] were significantly different (P0.05). The incidence of pleural effusion in exfoliation group was lower than that in hepatectomy group (P0.05). There was no significant difference between the two groups in biliary leakage, abdominal hemorrhage, death and other complications (P0.05). There was no significant difference in postoperative mortality, improvement of symptoms and recurrence of hemangioma. Conclusion hepatectomy and extracapsular exfoliation are effective methods for the treatment of giant hepatic hemangioma. Extracapsulation of giant hepatic hemangioma was significantly better than that of hepatectomy in terms of operation time, intraoperative blood loss, intraoperative blood transfusion, hepatic blood flow occlusion time and hospitalization days, and the incidence of postoperative complications was lower. Extracapsular exfoliation of giant hemangioma of liver is a more safe, simple and efficient procedure, which is worth popularizing in clinical work.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.7
，
本文编号：2341719
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