肝癌手术中肝段门静脉染色并化疗栓塞的临床研究
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陈斌E-mail:chenb1970829@163.com

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江西省赣州市科技局基金资助项目(20070121)。


Clinical study on hepatic segmentectomy under segmental staining and intraoperative chemoembolization for primary liver cancer
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    摘要:

    目的:探讨肝段染色指导下肝段切除术和术中灌注化疗栓塞治疗肝癌的临床效果。
    方法42例肝癌手术治疗者,其中20例肝癌患者术中应用B超引导肝段门静脉阻断灌注化疗栓塞并肝段染色后肝切除术(观察组),22例应用常规肝切除术(对照组)。两组均术后定期复查肝功能、AFP,CT及MRI的变化,并随访。
    结果:观察组术中出血量为(295±105) mL, 输血量(280±85) mL,术后1周肝功能指标超出正常范围者占15%(3/20),术后并发症发生率40.0%(8/20),术后3年生存率60.0%,术后3年局部复发率35.0%;对照组术中出血量(490±140) mL, 输血量(370±105) mL,术后1周肝功能指标超出正常范围病例占40.9%(9/22),术后并发症发生率45.5%(10/22),术后3年生存率40.91%,术后3年局部复发率68.2%。观察组术中出血量、输血量、术后1周肝功能指标超出正常范围者比率、术后3年局部复发率均显著低于对照组(P<0.05),观察组术后3年生存率显著高于对照组(P<0.05),两组术后并发症发生率比较差异无统计学意义(P>0.05)。
    结论:肝段门静脉阻断灌注化疗栓塞并肝段染色后肝切除术可减少术后并发症,降低术后复发率,提高患者的生存率。

    Abstract:

    Objective: To explore the clinical efficacy of hepatic segmentectomy under segmental staining and intraoperative chemoembolization for primary liver cancer(PLC).
    Methods: Twenty cases of liver cancer underwent hepatic segmentectomy under segmental staining and intraoperative chemoembolization (observed group), the results were compared with 22 cases of PLC after treated by routine hepatectomy(control group).AFP,CT and MRI were regularly used after hepatectomy to evaluate the outcome.
    Results: In observed group, the operative blood loss was(295±105)mL,blood transfusion was(280±85)mL,  liver function levels were in  the normal range accounted for 15%(3/20) one week  postoperatively, the incidence of postoperative complications was 40% (8/20),the postoperative 3-year survival rate was 60%,and the postoperative local recurrence rate was 35%; while in the control group, these parameters were (490±140)mL, (370±105)mL,  40.9%(9/22), 45.5%(10/22),  40.91% and 68.18% respectively. In observed group, the operative blood loss, blood transfusion, cases with liver function levels in the normal range, the incidence of postoperative complications, postoperative 3-year survival rate, and postoperative local recurrence rate were significantly lower than those in the control group(P<0.05). The postoperative 3-year survival rate in observed group was significantly higher than that in the control group (P<0.05),but the incidence of postoperative complications in the two groups was not statistically different (P>0.05).
    Conclusions: The hepatic segmentectomy under segmental staining and intraoperative chemoembolization for PLC may reduce postoperative complications,lower postoperative relapse rate and improve survival rate.

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陈斌|王春华|王小农|何晓.肝癌手术中肝段门静脉染色并化疗栓塞的临床研究[J].中国普通外科杂志,2010,19(1):69-72.
DOI:10.7659/j. issn.1005-6947.2010.01.016

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  • 收稿日期:2009-05-06
  • 最后修改日期:2009-07-28
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  • 在线发布日期: 2010-01-15