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河北医学  2019, Vol. 25 Issue (5): 811-815    DOI: 10.3969/j.issn.1006-6233.2019.05.25
  临床研究 本期目录 | 过刊浏览 | 高级检索 |
规则与非规则切除单发小肝癌的长期预后及影响因素分析
黄凤德, 胥丹, 安志明, 谢田伟
四川省绵阳市四〇四医院普外一科, 四川 绵阳 621000
Analysis on Long-term Prognosis and Influencing Factors of Regular and Irregular Resection of Single Small Liver Cancer
HUANG Fengde, XU Dan, AN Zhiming, et al
Mianyang 404 Hospital in Sichuan, Sichuan Mianyang 621000, China
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摘要 目的: 分析规则与非规则切除单发小肝癌的长期预后及影响因素。方法: 选择我院2010年5月至2013年5月收治的单发小肝癌患者89例,按随机数字表法分为40例A组和49例B组,A组采用规则切除,B组采用非规则切除。比较两组手术情况、并发症发生情况,分析单发小肝癌患者长期预后的影响因素。结果: 非规则切除组手术时间、术中失血量、切缘大小及住院时间均低于规则切除组,比较有统计学差异(P<0.05)。两组总并发症发生率比较无统计学差异(P>0.05)。单因素分析显示,不同性别、年龄、Child-pugh分级、血清HbsAg、CGT、AEP、总胆红素、ALT水平、肿瘤切缘大小、肝门阻断时间、出血量及是否规则切除组5年生存率比较无统计学差异(P>0.05),不同白蛋白水平、肿瘤大小、肿瘤包膜、是否长期吸烟及术中输血组5年生存率比较有统计学差异(P<0.05)。Cox模型回归分析显示肿瘤大小及长期吸烟为影响单发小肝癌患者预后的独立危险因素,肿瘤包膜完整及白蛋白水平是其保护因素。结论: 单发小肝癌的长期预后和多种因素相关,规则性肝切除不是独立的预后影响因素,临床应根据患者肿瘤解剖位置及肝功能储备情况选择最佳术式。
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黄凤德
胥丹
安志明
谢田伟
关键词 单发小肝癌规则切除非规则切除长期预后影响因素    
AbstractObjective: To analyze the long-term prognosis and influencing factors of regular and irregular resection of single small liver cancer. Methods: 89 patients with single small liver cancer who treated from May 2010 to May 2013 in our hospital, according to random number table method, those patients were divided into 40 cases of A group and 49 cases of B group,group A used regular resection and group B used irregular resection. The operation and complications in both groups were compared, and the influencing factors of long-term prognosis were analyzed. Results: The operation time, intraoperative blood loss, margin size and length of hospital stay in the irregular resection group were lower than those in the regular resection group (P<0.05). the total complication rate in the both groups was no significant difference (P>0.05). Univariate analysis showed that gender, age, Child-pugh grade, serum HbsAg, CGT, AEP, total bilirubin, ALT level, tumor margin, hepatic occlusion time, bleeding volume, and whether the rule was removed for 5 years were no significant difference in survival rate (P>0.05). there were significant differences in 5-year survival rates between different albumin levels, tumor size, tumor capsule, long-term smoking, and intraoperative blood transfusion (P<0.05). Cox regression analysis showed that tumor size and long-term smoking were independent risk factors for the prognosis of patients with single hepatocellular carcinoma, tumor envelope integrity and albumin levels were protective factors. Conclusion: The long-term prognosis of small hepatocellular carcinoma is related to various factors. Regular hepatectomy is not an independent prognostic factor, and the optimal operation should be selected clinically according to the tumor anatomical location and liver function reserve of patients.
Key wordsSingle small liver cancer    Regular excision    Irregular excision    Long-term prognosis    Factors affecting the
    
基金资助:四川省自然科学基金项目,(编号:2012JC031)
引用本文:   
黄凤德, 胥丹, 安志明, 谢田伟. 规则与非规则切除单发小肝癌的长期预后及影响因素分析[J]. 河北医学, 2019, 25(5): 811-815.
HUANG Fengde, XU Dan, AN Zhiming, et al. Analysis on Long-term Prognosis and Influencing Factors of Regular and Irregular Resection of Single Small Liver Cancer. HeBei Med, 2019, 25(5): 811-815.
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