摘要
目的比较和评价腹腔镜外囊完整切除与开腹外囊完整切除治疗肝囊型包虫病(HCE)的临床疗效。方法回顾性分析2015年1月至2019年3月收治的行肝包虫外囊完整切除术治疗HCE患者中的56例患者临床资料,根据术式不同分为两组,腹腔镜组19例,开腹组37例。采用SPSS21.0统计软件分析,两组患者术中术后相关指标以(±s)表示,采用独立样本t检验;术后相关并发症发生率采用χ^2检验;P<0.05差异有统计学意义。结果56例患者均成功完成手术达到临床治愈,围术期无严重并发症及死亡发生。相较于开腹组,虽然腹腔镜组手术时间较长(P<0.05);但术中出血量、术后住院天数、带管时间、术后首次下床时间、肛门排气时间方面均较低(P<0.05)。腹腔镜组总体并发症发生率(26.3%)明显低于开腹组(64.9%),差异有统计学意义(P<0.05)。结论腹腔镜肝包虫外囊完整切除术在具备安全性、有效性的同时,具有微创、术后恢复快、住院时间短、并发症发生率低、切口美观等多诸多优势。但术前准确的病情评估、术中精准的外科操作是手术成功的重要保证。
Objective To compare and evaluate the clinical efficacy of laparoscopic complete resection of hepatic hydatid cyst and open surgery in the treatment of cystic echinococcosis(HCE).Methods 56 patients with HCE who received complete excision of the echinococcal cyst of liver from January 2015 to March 2019 were i were retrospectively analyzed.according to different operative methods,They are divided into two groups,19 underwent laparoscopic surgery as the laparoscopic group,37 routine laparotomy as the laparotomy group.The operative time,intraoperative blood loss and postoperative complications were compared between the two groups.SPSS21.0 statistical software was used for analysis.Intraoperative and postoperative indicators of the two groups of patients were expressed as(±s),and compared with independent t test.The incidence of postoperative complications were examined by chi square test.The difference was statistically significant when P<0.05.Results In this study,the operation were completed in all the cases and clinical cure were achieved,and no serious complications or death was found during the perioperative period.Compared with the laparotomy group,the laparoscopic group had a longer operation time(P<0.05).However,intraoperative blood loss,postoperative length of hospital stay,time with catheter,time of first postoperative get out of bed,and time of anal exhaust were all lower(P<0.05).The overall incidence of complications in the laparoscopic group(26.3%)was significantly lower than that in the laparotomy group(64.9%),and the difference was statistically significant(P<0.05).Conclusion In addition to safety and effectiveness,laparoscopic complete resection of the echinococcal cyst has many advantages,such as minimally invasive,rapid postoperative recovery,short hospital stay,low incidence of complications,and beautiful incision.However,accurate preoperative evaluation and accurate surgical operation are important guarantees for the success of the operation.
作者
杨鹏
吐尔干艾力·阿吉
郭强
钟锴
冉博
蒋铁民
邵英梅
Yang Peng;Tuerganaili·Aji;Guo Qiang;Ran Bo;Jiang Tiemin;Shao Yingmei(Department of Hepatobiliary&Hydatid Diseases,Digestive&Vascular Surgery Center,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China)
出处
《中华普外科手术学杂志（电子版）》
2020年第3期293-296,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
新疆维吾尔自治区“十三五”重点学科(高峰学科)[新教研(2016)7号]
新疆维吾尔自治区自然科学基金(2018D01C220)
国家自然科学基金(81660108)
国家重点专项(2017YFC0909903)
省部共建中亚高发病成因与防治国家重点实验室(SKL-HIDCA-2017-1)。
关键词
腹腔镜
肝囊型包虫病
肝包虫外囊完整切除
Laparoscopes
Hepatic cystic echinococcosis
Complete excision of the echinococcal cyst of liver
