不同手术治疗原发性肝癌疗效及其预后影响因素分析

目的：探讨比较解剖式和非解剖式肝切除术治疗原发性肝癌（HCC）的手术疗效及其影响因素分析。方法将78例HCC患者按照手术方式的不同随机分为解剖式和非解剖式肝切除术组，每组各39例，对比两种手术方式的临床疗效，术中出血量、手术时间、住院时间、术后平均禁食时间、平均腹腔引流时间、并发症发生率及生存率指标，并筛选影响预后的因素。结果术后解剖组和非解剖组的总体有效率和住院时间比较差异无统计学意义（P＞0．05）；但解剖组平均出血量、禁食时间、腹腔引流时间、并发症的发生率均明显低于非解剖组，而手术时间则明显高于非解剖组，差异均有统计学意义（P＜0．05）；解剖组生存率优于非解剖组，且与肿瘤大小、门静脉浸润、切缘和乙肝显著相关（P＜0．05）。结论解剖式肝切除术虽操作复杂，但治疗HCC的临床疗效和安全性均优于非解剖式切除术，且能更好提高术后生存率。

Effects comparison of different liver resection surgery in patients with hepatocellular carcinoma and analysis of factors influencing prognosis

Objective To compare the effects of anatomical and non-anatomical liver resection surgery in pa-tients with hepatocellular carcinoma （HCC） and to analyze the factors influencing prognosis .Methods A total of 78 patients with HCC were divided into anatomical and non-anatomical liver resection group ,with 39 cases in each group .Clinical efficacy ,blood loss ,operative time ,duration of hospitalization ,postoperative mean fasting time ,average peritoneal drainage time ,incidence of complications and indicators of survival rate were compared between the two groups ,and factors influencing prognosis were screened .Results There were no significant differences of clinical ef-ficiency and duration of hospitalization between the two groups （P〉0 .05） .The average amount of bleeding ,fasting time ,peritoneal drainage time and incidence of complications in anatomical group were significantly lower than non-anatomical group ,while the operative time was longer（P〈0 .05） .Survival rate of anatomical group was higher than non-anatomical group ,which was correlated with tumor size ,portal vein invasion ,surgical margin and hepatitis B（P〈0 .05） .Conclusion Although anatomic liver resection operation might be complex ,but its efficacy and safety in the treatment of HCC could be better than non-anatomical resection ,and could improve survival rate .