目的

比较不同入路行肝切除术治疗原发性肝细胞癌的效果。

方法

回顾性分析2019 年1 月至2023 年1 月接受肝切除术的103 例原发性肝细胞癌患者资料，依据手术入路不同分为悬吊组（实施绕肝悬吊前入路，n=53 例）与传统组（行传统入路，n=50 例）。采用SPSS 25.0 软件分析数据，术中失血量、手术时间等计量资料以（x± s）表示，行独立样本t 检验；术后并发症发生情况等计数资料行χ²检验；肝功能分级等级资料采用秩和检验；生存分析采用Kaplan-Meier 法并行Log-Rank 检验。以P＜0.05 为差异有统计学意义。

结果

两组患者术中出血量、血浆输注量比较，悬吊组少于传统组（P＜0.05）；两组患者手术时间、术后进食时间、下床时间比较，差异均无统计学意义（P＞0.05）；悬吊组患者住院时间、并发症发生率均低于传统组（P＜0.05）；两组患者随访1 年期间无进展生存率、总生存率比较，悬吊组高于传统组（P＜0.05）。

结论

较传统入路，经绕肝悬吊前入路行肝切除术治疗原发性肝细胞癌可减少术中出血量、血浆输注量，降低术后并发症发生率，促进患者恢复，且有利于提高患者短期生存率。

Objective

To compare the effects of hepatectomy with different approaches in the treatment of primary hepatocellular carcinoma.

Method

The data of 103 patients with primary hepatocellular carcinoma who underwent hepatectomy from January 2019 to January 2023 were retrospectively analyzed.According to different surgical approaches， they were divided into suspension group （n=53 cases with anterior liver suspension approach） and traditional group （n=50 cases with traditional approach）.SPSS 25.0 software was used to analyze the data.Intraoperative blood loss， operation time and other measurement data were expressed as （x ± s）， and independent sample t test was performed.The incidence of postoperative complications were counted by χ² test.Rank Sum test was used for liver function grades.Kaplan-Meier method and Log-Rank test were used for survival analysis.P＜0.05 was considered to be statistically significant.

Results

The amount of intraoperative blood loss and plasma infusion in suspension group was lower than that in traditional group（P＜0.05）.There was no significant difference in operation time， postoperative feeding time and getting out of bed time between the two groups （P＞0.05）.The length of hospital stay and incidence of complications in suspension group were lower than those in traditional group （P＜0.05）.The progression-free survival rate and overall survival rate of the two groups were higher in the suspension group than in the traditional group （P＜0.05）.

Conclusion

Compared with the traditional approach， hepatectomy by suspending the liver around the anterior approach can reduce the amount of intraoperative blood loss and plasma infusion， reduce the incidence of postoperative complications， promote the recovery of patients， and improve the short-term survival rate of patients.