[1]辛大平),彭 彬),黄 明),等.精准肝切除与非规则性肝切除治疗肝内胆管结石效果比较[J].郑州大学学报(医学版),2019,(05):762-765.[doi:10.13705/j.issn.1671-6825.2018.08.144]
 XIN Daping),PENG Bin),HUANG Ming),et al.Comparison of effects of precise hepatectomy and irregular hepatectomy in treatment of hepatolithiasis[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2019,(05):762-765.[doi:10.13705/j.issn.1671-6825.2018.08.144]
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精准肝切除与非规则性肝切除治疗肝内胆管结石效果比较()
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2019年05期
页码:
762-765
栏目:
应用研究
出版日期:
2019-09-20

文章信息/Info

Title:
Comparison of effects of precise hepatectomy and irregular hepatectomy in treatment of hepatolithiasis
作者:
辛大平1)彭 彬1)黄 明1)黄纪伟2)
1)广安市人民医院普外一科 四川广安 638000;2)四川大学华西医院肝脏外科 成都 610041
Author(s):
XIN Daping1) PENG Bin1) HUANG Ming1) HUANG Jiwei2)
1)The First Department of General Surgery, Guang'an People's Hospital, Guang'an,Sichuan 638000; 2)Department of Liver Surgery, West China Hospital, Sichuan University,Chengdu 610041
关键词:
肝内胆管结石 精准肝切除 非规则性肝切除
Keywords:
hepatolithiasis precise hepatectomy irregular hepatectomy
分类号:
R657.3
DOI:
10.13705/j.issn.1671-6825.2018.08.144
摘要:
目的:比较精准肝切除与非规则性肝切除治疗肝内胆管结石的效果。方法:胆管结石患者100例,50例行非规则性肝切除治疗(对照组),50例给予精准肝切除治疗(观察组),比较两组手术时间、术中出血量、住院时间、住院费用,肝功能指标[丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、总胆红素(TBIL)]、血清学指标(NF-κB、IL-17、IL-23)、应激指标[皮质醇(Cor)、肾上腺素(E)、去甲肾上腺素(NE)]的变化及并发症发生率。结果:观察组的手术时间长于对照组,住院时间均短于对照组,术中出血量和住院费用少于对照组(P<0.001)。观察组治疗前后血清ALT、ALP、TBIL差值和血清NF-κB、IL-17、IL-23、Cor、E、NE差值均小于对照组(P<0.001)。观察组并发症发生率为10.0%,低于对照组的34.0%(P<0.001)。结论:精准肝切除治疗肝内胆管结石效果显著,安全性较高。
Abstract:
Aim:To observe the curative effects of precise hepatectomy and irregular hepatectomy in the treatment of hepatolithiasis.Methods:A total of 100 patients with hepatolithiasis were allocated into control group(n=50)and the observation group(n=50). The control group was treated by irregular hepatectomy while the observation group was treated by precise hepatectomy.The surgical time, intraoperative blood loss, length of hospital stay, hospitalization expenses, liver function indexes[alanine aminotransferase(ALT), alkaline phosphatase(ALP), total bilirubin(TBIL)], serological markers(NF-κB,IL-17,IL-23), stress indexes [cortisol(Cor), adrenaline(E), norepinephrine(NE)] and the incidence of complications were compared between the two groups.Results:The surgical time of the observation group was longer than that of the control group, and the length of hospital stay was shorter than that of the control group(P<0.001). The intraoperative blood loss and hospitalization expenses of the observation group were less than those of the control group(P<0.001). After treatment, the differences of ALT, ALP, TBIL, NF-κB, IL-17, IL-23, Cor, E and NE in the observation group were significantly lower than those in the control group(P<0.001).The total incidence of complications in the observation group was significantly lower than that in the control group(10.0%vs 34.0%, P<0.001).Conclusion:Precise hepatectomy is effective in the treatment of hepatolithiasis with high safety.

参考文献/References:

[1] 马宁,李博,丛子红,等.精准肝切除术与非规则性肝切除术治疗肝内胆管结石患者临床疗效对比[J].西部医学,2017,29(12):1709
[2] 余培,钟艳霞.肝内胆管结石患者行腹腔镜下肝叶切除术的临床效果研究[J].海南医学院学报,2016,22(6):568
[3] ALBERS C,WESTKOTT M,PAWELZIK K.Learning of precise spike times with homeostatic membrane potential dependent synaptic plasticity[J].PLoS One,2016,11(2):e0148948
[4] 刘子旭,曹迁,凌晓锋.肝内胆管结石病治疗进展[J].实用医学杂志,2016,32(4):513
[5] 付宁,马明坤,罗道蕴,等.精准肝切除术与非规则性肝切除术治疗肝内胆管结石的临床分析[J].成都医学院学报,2016,11(5):565
[6] 肖卫星,周君,顾梦佳,等.精准肝切除在肝内胆管结石手术治疗中的应用[J].中国普通外科杂志,2016,25(2):191
[7] BAILEY ME,EMEL'YANENKO VV.Dynamical evolution of Halley-type comets[J].Mon Not R Astron Soc,2018,278(4):1087
[8] 鲁德斌,李乔林.规则性肝切除并胆管镜在肝内胆管结石治疗中的应用研究[J].海南医学院学报,2016,22(6):562
[9] 骆伟,孟文勃,岳平,等.胆肠吻合术后胆管结石复发的内镜外科治疗进展[J].中华消化内镜杂志,2016,33(2):130
[10]王甸北,赵礼金,涂奎,等.解剖性肝切除术治疗肝内胆管结石的效果观察[J].临床肝胆病杂志,2017,33(1):102
[11]熊小勇,习举云,徐降兴.三种不同手术方式治疗肝内胆管结石的效果评价[J].安徽医药,2016,20(5):929
[12]陈晓鹏,张卫东.腹腔镜精准肝切除治疗肝内胆管结石病[J].肝胆外科杂志,2016,24(2):87
[13]周凌雪,陈畅,张宗泽,等.围术期感染和手术应激诱发的炎症反应与小鼠术后认知功能障碍的关系[J].中华麻醉学杂志,2016,36(11):1345
[14]薛冬冬,脱红芳,彭彦辉.精准肝切除技术在减轻肝切除术后炎症方面的作用[J].中国普通外科杂志,2016,25(7):1063
[15]林健群,洪建文,杨熙,等.精准肝切除在肝胆管结石病中的临床应用分析[J].腹腔镜外科杂志,2016,21(2):112
[16]曾庆彬,朱磊,赵晰,等.肝切除治疗复杂性肝内胆管结石的研究进展[J].医学综述,2016,22(23):4634
[17]陈继业,罗渝昆,姜凯,等.射频消融肝蒂毁损联合肝动脉阻断在精准肝切除中的作用[J].解放军医学杂志, 2016,41(8):636

备注/Memo

备注/Memo:
【基金项目】四川省卫生和计划生育委员会基金项目(17PJ007)
【作者简介】辛大平,男,1963年1月生,本科,副主任医师,研究方向:肝胆胰腺外科,E-mail:sko669045@163.com
更新日期/Last Update: 2019-09-20