腹腔鏡與開腹手術治療肝囊腫的療效與安全性分析

鄭海明

[摘要] 目的 對肝囊腫患者應用腹腔鏡手術和開腹手術進行治療并對其療效及安全性進行分析研究。方法 方便選擇2017年6月—2019年4月間到該院就診的100例肝囊腫患者作為研究對象，根據手術方案給予的不同將100例患者分為腹腔組和開腹組，每組50例，采用腹腔鏡下小切口術對腹腔組患者進行治療，采用傳統開腹手術對開腹組患者進行治療。對腹腔組和開腹組患者的手術情況、術后并發癥以及肝功能指標情況進行分析比較。 結果 在術中出血量、胃腸功能恢復時間、手術時間以及住院時間上，腹腔組情況均好于開腹組，差異有統計學意義（術中出血量t=27.693，P=0.000;胃腸功能恢復時間t=20.416，P=0.000;手術時間t=24.691，P=0.000;住院時間t=18.607，P=0.000）;腹腔組出現切口感染、膽瘺、腹水等并發癥共2例，發生率為4.00%，開腹組出現共8例，發生率為16.00%，腹腔組明顯低于開腹組，組間比較差異有統計學意義（χ2=4.000，P=0.046）;治療后，腹腔組患者的TBil、DBil、AST以及ALT等肝功能指標均高于開腹組，差異有統計學意義（t=8.320，P=0.000;t=18.694，P=0.000;t=2.362，P=0.020;t=3.391，P=0.001）。結論 相比較傳統開腹術，對肝囊腫患者應用腹腔鏡下小切口術進行治療，可以明顯改善患者的術中情況及肝功能水平，并減小并發癥的發生率，安全有效。

[關鍵詞] 肝囊腫;腹腔鏡;開腹手術;安全性;療效

[Abstract] Objective To treat patients with liver cysts by laparoscopy and laparotomy， and analyze their efficacy and safety. Methods A total of 100 patients with liver cysts who visited the hospital from June 2017 to April 2019 were selected as the research subjects. According to the different surgical schemes， 100 patients were convenient divided into the abdominal cavity group and the open abdominal group， 50 in each group. A small laparoscopic incision was used to treat patients in the abdominal cavity group， and a traditional open surgery was used to treat patients in the abdominal group. The surgical conditions， postoperative complications， and liver function parameters of the patients in the abdominal and open groups were analyzed and compared. Results In terms of intraoperative blood loss， recovery time of gastrointestinal function， operation time and hospitalization time， the condition of the abdominal cavity group was better than that of the open group，and the difference was statistically significant （intraoperative blood loss t=27.693，P=0.000; recovery time of gastrointestinal function t=20.416， P=0.000; operation time t=24.691， P=0.000; hospitalization time t=18.607， P= 0.000） ; incision infection， biliary fistula， 2 cases of complications such as ascites， with an incidence rate of 4.00%. A total of 8 cases appeared in the open group， the incidence rate was 16.00%. The abdominal group was significantly lower than the open group，and the difference was statistically significant; after treatment， patients in the abdominal group had TBil， DBil， AST， and ALT and other liver function indexes were higher than those of the open abdominal group， and the differences were statistically significant（χ2=4.000， P=0.046;t=8.320，P=0.000;t=18.694，P=0.000;t=2.362，P=0.020;t=3.391，P=0.001）.Conclusion Compared with traditional laparotomy， the treatment of patients with hepatic cysts by laparoscopic small incision can significantly improve the intraoperative situation and liver function level of patients， and reduce the incidence of complications. It is safe and effective.