运用精细肝脏外科理念治疗肝血管瘤

目的：探讨运用精细肝脏外科理念治疗肝血管瘤的价值。方法：回顾性分析行肝切除的52例肝血管瘤患者的临床资料，其中采用精细肝切除术23例，传统肝切除术29例。结果：52例患者均手术成功，术后顺利康复，术中及围手术期无严重并发症，无死亡发生。精细肝切除组与传统肝切除组比较，前者手术时间延长[（128.0±25.7）min vs.（100.9±20.4）min]（P<0.05），术中出血、输血例数比例差异均无统计学意义（均P>0.05），术后住院时间明显缩短[（7.0±1.5）d vs.（8.6±1.5）d]（P<0.05），术后丙氨酸氨基转移酶（ALT）峰值[（277.5±189.3）U/L vs.（960.0 ±635.0）U/L]，门冬氨酸氨基转移酶（AST）峰值[（254.2 ±191.4）U/L vs.（838.5±677.1）U/L]以及术后并发症发生率均明显降低（8.7% vs. 31.0%）（均P<0.05）。结论：运用精细肝脏外科理念治疗肝血管瘤安全有效，较传统肝切除术具有明显优势。

Use of precise liver surgery concept in treatment of liver hemangioma

Objective: To assess the clinical value of using the concept of precise liver surgery in the treatment of liver hemangioma.Methods: The clinical data of 52 patients with liver hemangioma undergoing hepatectomy during the past three and a half years were retrospectively analyzed. Of the patients, 23 cases underwent precise hepatectomy, and another 29 cases underwent traditional hepatectomy.Results: The operations were performed successfully in all patients. All of them recovered well with no serious complications during operation and the perioperative period, and no death occurred. In precise hepatectomy group, compared with the traditional hepatectomy group, there was prolonged operative time [(128.0±25.7) min vs. (100.9±20.4) min] (P<0.05), and similar intraoperative blood loss and ratio of blood transfusion requirement (both P>0.05), but reduced length of postoperative hospital stay [(7.0±1.5) d vs. (8.6±1.5) d] (P<0.05), and postoperative peak levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) [(277.5±189.3) U/L vs. (960.0±635.0) U/L; (254.2±191.4) U/L vs. (838.5±677.1) U/L], as well as decreased postoperative complications (8.7% vs. 31.0%) (all P<0.05).Conclusion: Precise liver surgery is safe and effective for liver hemangioma with significant advantages versus traditional hepatectomy.