不同手术切除方式治疗紧邻肝门及大血管的肝血管瘤疗效及安全性分析

摘要

目的：分析不同手术切除方式治疗紧邻肝门及大血管的肝血管瘤疗效及安全性．方法：回顾性分析本院2009-02／2013-02收治的82例紧邻肝门及大血管的肝血管瘤病例资料，其中采用肝切除术55例（67．07％），其中肝楔形切除术15例（27．27％），肝叶切除14例（25．45％），左半肝切除12例（21．82％），右半肝切除8例（14．55％），右3叶切除6例（10．91％），动脉栓塞术14例（17．07％）及肝血管剥离术13例（15．86％），通过比较不同手术方式治疗的患者手术时间、住院时间、术后并发症及临床治疗有效率，分析不同手术方式治疗紧邻肝门及大血管的肝血管瘤疗效及安全性．结果：在治疗紧邻肝门及大血管的肝血管瘤的手术时间、住院时间、术后并发症及临床治疗有效率方面肝叶切除术治疗方式优于动脉栓塞术及肝血管剥离术，差异具有统计学意义（P ＜0．05）．结论：肝切除术在紧邻肝门及大血管的肝血管瘤疗效确切，并发症少，临床治疗有效率及患者满意度高，该手术方式值得临床推广应用．%AIM:To investigate the curative effect and safety analysis on the treatment of hepatic hemangioma adjacent to porta hepatis and great vessels with different surgical excision.METH-ODS:From February 2009 to February 2013,82 patients in our hospital with hepatic hemangioma adjacent to porta hepatis and great vessels were chosen and analyzed retrospectively.Fifty five patients (67.07%)were treated with hepatectomy,of which 15 (27.27%) were treated with hepatic wedge resection, 14 (25.45%)were treated with hepatic lobectomy,12 (21.82%) were treated with left hemihepatectomy,8 (14.55%)were trea-ted with right hemihepatectomy,and 6 (10.91%)were treated with right hepatic trisegmentectomy. Fourteen patients (17.07%) were treated with arterial embolism and 13 (15.86%)were treated with hepatic vascular dissection.The curative effect and safety of treatments of hepatic hemangioma ad-jacent to porta hepatis and great vessels with different surgical ex-cision were analyzed by the comparison of operation duration, length of stay,postoperative complications and clinical efficiency. RESULTS:Comparing the operation duration,length of stay, postoperative complications and clinical efficiency in the treatment of hepatic hemangioma adjacent to porta hepatis and great vessels, hepatic lobectomy was better than arterial embolism and hepatic vascular dissection.The difference was statistically significant (P <0.05 ).CONCLUSION:The treatment with hepatectomy of hepatic hemangioma adjacent to porta hepatis and great vessels was effective with fewer complications.The clinical efficiency and patients'satisfaction was higher.It is worth further promotion in clinics.