肝切除手术治疗肝包虫病的疗效及对患者预后和肝功能的影响

目的:探讨肝切除手术治疗肝包虫病的疗效及对患者预后和肝功能的影响。方法:选取2015年2月-2018年5月期间我院收治的肝包虫病患者103例为研究对象,所有患者根据手术方式的不同分为A组(n=51,行外膜内完整外囊摘除术)和B组(n=52,行肝切除手术),比较两组患者围术期临床指标、肝功能指标、并发症发生情况,随访半年,记录两组患者随访期间死亡及原位复发情况。结果:B组术中出血量少于A组,手术时间、术后拔管时间以及住院时间均短于A组,组间比较差异有统计学意义(P0.05)。与术前比较,两组患者术后3 d、术后7 d谷丙转氨酶、胆红素以及谷草转氨酶均升高,但B组低于A组(P0.05);与术前比较,两组患者术后3 d、术后7 d白蛋白降低,但B组高于A组(P0.05);与术后3 d比较,两组患者术后7d谷丙转氨酶、胆红素以及谷草转氨酶均降低,白蛋白升高(P0.05)。B组术后并发症总发生率为7.69%(4/52),低于A组的23.52%(12/51),组间比较差异有统计学意义(P0.05)。两组随访期间无患者死亡,原位复发率比较差异均无统计学意义(P0.05)。结论:肝切除手术治疗肝包虫病患者安全有效,可减少术中出血量,促进患者术后康复,减轻手术对肝功能的影响,且术后复发率较低,患者预后较好。

Efficacy of Hepatectomy for Hepatic echinococcosis and Its Effect on Prognosis and Liver Function

ABSTRACT Objective: To investigate the effect of hepatectomy for hepatic echinococcosis and its influence on prognosis and liver function. Methods: 103 patients with hepatic hydatidosis who were admitted to our hospital from February 2015 to May 2018 were selected as the research objects. All patients were divided into group A (n=51, complete extracapsular extraction) and group B (n=52, hepatectomy) according to different surgical methods. The perioperative clinical indicators, liver function indicators and complications were compared between the two groups. During the follow-up period of half a year, the death and in situ recurrence of the two groups were recorded. Results: The amount of intraoperative bleeding in group B was less than that in group A. The operation time, extubation time after operation and hospitalization time were shorter than those in group A. There was significant difference between the two groups (P<0.05). Compared with pre-operation, the glutamic-alanine aminotransferase, bilirubin and glutamic-oxaloacetic aminotransferase increased in two groups at 3 days after operation and 7 days after operation, but group B was lower than group A (P<0.05). Compared with pre-operation, the albumin in group B was lower than that in group A at 3 days and 7 days after operation, but group B was higher than group A (P<0.05). Compared with 3 days after operation, the glutamic-alanine aminotransferase, bilirubin and glutamic-oxaloacetic aminotransferase decreased and albumin increased in two groups at 7 days after operation(P<0.05). The total incidence of postoperative complications in group B was 7.69% (4/52), which was significantly lower than that in group A 23.52% (12/51), there was significant difference between groups(P<0.05). There was no patient died during the follow-up period in both groups, there was no significant difference in the recurrence rate in situ between the two groups(P>0.05). Conclusion: Hepatectomy is safe and effective in the treatment of hepatic echinococcosis. It can reduce the amount of bleeding during operation, promote the recovery of patients after operation, and reduce the effect of operation on liver function, the recurrence rate is low and the prognosis of patients is good.