肝切除术和包膜外剥脱术治疗肝血管瘤的效果比较

陈凯; 李向农; 刘坤; 南云广; 杨军

doi:10.3969/j.issn.1001-5256.2017.04.020

肝切除术和包膜外剥脱术治疗肝血管瘤的效果比较

DOI: 10.3969/j.issn.1001-5256.2017.04.020

1. 徐州医科大学附属医院肝胆外科
2. 南京鼓楼医院集团宿迁市人民医院普外科

详细信息

中图分类号: R735.7
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出版历程
- 收稿日期: 2016-10-26
- 出版日期: 2017-04-20

Clinical effect of hepatectomy versus extracapsular peeling in treatment of hepatic hemangioma

Department of Hepatobiliary Surgery, The Affiliated Hospital of Xuzhou Medical University

摘要

摘要: 目的对比分析肝切除术和包膜外剥脱术治疗肝血管瘤的临床疗效,为临床手术方式的选择提供依据。方法回顾性分析2010年1月-2016年5月在徐州医科大学附属医院行手术治疗的115例患者临床资料。根据手术方法的不同分成剥脱组（n=79）和肝切组（n=36）,进一步根据肿瘤直径将所有患者分成2个亚组进行分层比较:肿瘤直径在510 cm的肝大血管瘤患者89例,分为大剥脱组64例和大肝切组25例;肿瘤直径>10 cm的巨大肝血管瘤26例,分为巨大血管瘤剥脱组15例和巨大血管瘤切除组11例。分别比较2组患者之间术前、术中、术后的相关临床资料。正态分布的计量资料2组间比较采用独立样本t检验;非正态分布数据2组间比较采用Mann-Whitney U检验。分类变量采用χ2检验和Fisher确切概率法进行2组间比较。结果血管瘤剥脱术和肝切除术患者的术中出血量[300（200400）ml vs 300（225500）ml]、手术时间[120（105160）min vs 140（951
- 肝肿瘤 /
- 血管瘤 /
- 肝切除术 /
- 剥脱术
Abstract: Objective To investigate the clinical effect of hepatectomy versus extracapsular peeling in the treatment of hepatic hemangioma, and to provide a basis for selection of surgical procedure in clinical practice.Methods A retrospective analysis was performed for the clinical data of 115 patients who underwent surgical treatment in The Affiliated Hospital of Xuzhou Medical University from January 2010 to May2016.According to the surgical procedure, these patients were divided into peeling group (79 patients) and hepatectomy group (36 patients) .According to the tumor diameter, the patients were further divided into two subgroups for stratified comparison:89 patients with hepatic hemangioma who had a tumor diameter of 5-10 cm were divided into large peeling group with 64 patients and large hepatectomy group with 25 patients; 26 patients with a tumor diameter of >10 cm were divided into giant hemangioma peeling group with 15 patients and giant hemangioma hepatectomy group with 11 patients.The preoperative, intraoperative, and postoperative clinical data were compared between groups.The two-independent-samples t test was used for comparison of normally distributed continuous data, and the Mann-Whitney U test was used for comparison of non-normally distributed data between groups.The chi-square test and Fisher' s exact test were used for comparison of categorical data between groups.Results There were no significant differences between the hepatectomy group and the peeling group in intraoperative blood loss [300 (200-400) ml vs 300 (225-500) ml, Z=-1.065, P=0.287 ], time of operation [120 (105-160) min vs 140 (95-150) min, Z =-0.036, P = 0.971], postoperative drainage volume [280 (165-520) ml vs 310 (105-546) ml, Z=0.413, P=0.679], length of hospital stay [16 (14-19) d vs 14 (13-19.5) d, Z=-1.283, P=0.200], and hospital costs (27 973.64 ± 10 028.32 RMB vs 28 680.85 ± 10 662.87 RMB, Z=-0.344, P=0.732) .The subgroup analysis showed that there were also no significant differences between the hepatectomy group and the peeling group in intraoperative blood loss, time of operation, postoperative drainage volume, length of hospital stay, and hospital costs (all P>0.05) .Conclusion Hepatectomy and hemangioma peeling have similar clinical effects in the treatment of hepatic hemangioma.
- liver neoplasms /
- hemangioma /
- hepatectomy /
- enucleation

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