血管瘤剥脱术和肝切除术治疗肝血管瘤患者疗效研究*

doi:10.3969/j.issn.1672-5069.2022.02.032

摘要/Abstract

摘要： 目的分析血管瘤剥脱术与肝切除术治疗肝血管瘤患者的疗效,并评估两种术式对围术期指标、术后并发症和肿瘤复发的影响。方法 2019年1月～2020年6月我院收治的58例肝血管瘤患者,其中31例接受血管瘤剥脱术治疗,27例接受肝切除术治疗,术后随访6个月。记录两组围术期指标、术后并发症和肿瘤复发情况。结果血管瘤剥脱术治疗组手术时间、术中出血量、术后腹腔引流量和术后住院时间分别为(120.6±25.4)min、(389.3±53.8)mL、(264.5±55.7)mL和(13.9±2.4)d,均显著低于肝叶切除术组[分别为(148.1±28.9)min、(468.2±59.2)mL、(321.8±63.4)mL和(15.8±3.3)d,P<0.05];术后,血管瘤剥脱术处理组腹腔出血、胆漏和胸腔积液等并发症发生率显著低于肝叶切除组(6.5%对35.0%,P<0.05);在术后随访6个月时,所有患者血管瘤均消失,未见肿瘤复发;在术后5 d,血管瘤剥脱术治疗组血清ALT水平为(71.3±15.3)U/L,血清AST水平为((49.1±9.3)U/L,显著低于肝叶切除术组[分别为(82.9±16.8)U/L和(57.3±11.2)U/L,P<0.05]。结论采取血管瘤剥脱术或肝切除术治疗肝血管瘤疗效均较好,也具有一定的安全性,但前者在减轻创伤和缩短术后恢复时间等方面更具优势,临床可结合实际情况选择合适的术式。

关键词: 肝血管瘤, 血管瘤剥脱术, 肝切除术, 治疗

Abstract: Objective The aim of this study was to analyze the efficacy of hemangioma stripping and hepatectomy in the treatment of patients with hepatic hemangioma and to evaluate the infleunce of the two surgical treatment on perioperative indicators, postoperative complications and prognosis. Methods A total of 58 patients with hepatic hemangioma were recruited in our hospital between January 2019 and June 2020, out of them, 31 patients were treated with hemangioma stripping and 27 patients were treated with hepatectomy. All patients were followed-up for 6 months. The perioperative indicators, postoperative complications and postoperative recurrence of tumor were recorded in the two groups. Results The surgical time, intraoperative blood loss, postoperative abdominal drainage volume and postoperative hospital stay in hemangioma stripping-treated patients were (120.6±25.4)min, (389.3±53.8)mL, (264.5±55.7)mL and (13.9±2.4)d, all significantly shorter or less than [(148.1±28.9)min, (468.2±59.2)mL,(321.8±63.4)mL and (15.8±3.3)d, respectively, P<0.05] in patients receiving hepatectomy; the post-operational complications, such as intraperitoneal hemorrhage, bile leakage and pleural effusion in hemangioma stripping-treated patients was significantly lower than in patients receiving hepatectomy (6.5% vs. 35.0%, P<0.05); six months after operation, all hepatic hemangioma in the two groups disappeared without recurrence; five days after surgery, serum alanine aminotransferase and aspartate aminotransferase levels in hemangioma stripping-treated patients were (71.3±15.3)U/L and ((49.1±9.3)U/L, both significantly lower than [(82.9±16.8)U/L and (57.3±11.2)U/L, respectively, P<0.05] in hepatectomy-treated patients. Conclusion Hemangioma stripping and hepatectomy are both effective and safe in treating patients with hepatic hemangioma, However, hemangioma stripping has some advantages in reducing trauma and shortening postoperative recovery time. The two surgical approaches have their own indications, and the surgeons might choose the appropriate surgery for the optimal efficacy.

Key words: Hepatic hemangioma, Hemangioma stripping, Hepatectomy, Therapy

刘海生, 宁纯民, 孙文兵. 血管瘤剥脱术和肝切除术治疗肝血管瘤患者疗效研究^*[J]. 实用肝脏病杂志, 2022, 25(2): 279-282.

Liu Haisheng, Ning Chunmin, Sun Wenbing. Efficacy of hemangioma stripping and hepatectomy in the treatment of patients with hepatic hemangioma[J]. Journal of Practical Hepatology, 2022, 25(2): 279-282.

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血管瘤剥脱术和肝切除术治疗肝血管瘤患者疗效研究^*

Efficacy of hemangioma stripping and hepatectomy in the treatment of patients with hepatic hemangioma

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