Page 121 - 南京医科大学学报自然科学版

第43卷第12期 南京医科大学学报（自然科学版）
2023年12月 Journal of Nanjing Medical University（Natural Sciences） ·1737 ·

·临床研究·

一项比较腹腔镜微波消融与腹腔镜肝切除治疗肝脏大血管瘤

的匹配病例研究并文献复习

张 龙，韩国勇，陈志强，张 峰，吴金道 *

南京医科大学第一附属医院肝胆中心，江苏 南京 210029

［摘 要］ 目的：通过比较腹腔镜微波消融与腹腔镜肝切除治疗肝脏大血管瘤的临床数据和文献复习，探讨肝脏大血管瘤的
治疗策略。方法：2020年1月—2022年12月共18例患者于南京医科大学第一附属医院确诊肝脏大血管瘤并行腹腔镜下血管
瘤微波消融术。以血管瘤大小、部位、体重指数为配对条件，选取18例同期行腹腔镜下血管瘤切除患者进行1∶1配对的病例对
照研究。比较两组患者手术用时、术中出血量、术后并发症、术后住院时间及术后第 1 天肝功能［丙氨酸氨基转移酶（alanine
transaminase，ALT），天门冬氨酸氨基转移酶（aspartate transaminase，AST）和总胆红素（total bilirubin，TBIL）］，近远期并发症，预
后等结果。结果：腹腔镜微波消融组患者手术时间低于腹腔镜手术组（P < 0.001），术中出血量低于腹腔镜手术组（P < 0.001），
术后住院时间低于腹腔镜手术组（P < 0.001）。两组患者在术后不良反应率（P > 0.05），术后第1天肝功能（ALT、AST、TBIL）比
较差异均无统计学意义（P > 0.05）。术后随访两组患者均未见中远期并发症。结论：腹腔镜微波消融治疗肝血管瘤效果确切，
手术安全，并且能显著减少术中出血，缩短手术时间和术后住院时间。
［关键词］ 肝脏大血管瘤；腹腔镜；肝切除；微波消融
［中图分类号］ R657.3 ［文献标志码］ A ［文章编号］ 1007⁃4368（2023）12⁃1737⁃06
doi：10.7655/NYDXBNS20231219

A matched case ⁃ control study and literature review comparing laparoscopic microwave
ablation and laparoscopic hepatectomy for the treatment of giant hepatic hemangioma
*
ZHANG Long，HAN Guoyong，CHEN Zhiqiang，ZHANG Feng，WU Jindao
Department of Hepatobiliary Center，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，
China

［Abstract］ Objective：To compare the clinical outcome and literature review of laparoscopic microwave ablation and laparoscopic
hepatectomy for the treatment of giant hepatic hemangioma，and explore the treatment strategiesgiant hepatic hemangioma. Method：
From January 2020 to December 2022，a total of 18 patientsdiagnosed with giant hepatic hemangiomaunderwent laparoscopic vascular
tumor microwave ablation at the First Affiliated Hospital of Nanjing Medical University. Based on the size，location，and body mass
index of the hemangioma，18 patients who underwent laparoscopic hemangioma resection duringthe same period were selected for a 1∶
1 matched case⁃control study. The surgical duration，intraoperative blood loss，postoperative complications，postoperative hospital stay，
andpostoperative liver function［alanine transaminase（ALT），aspartate transaminase（AST），and total bilirubin（TBIL）］on the first day
were compared between two groups of patients，as well as the short⁃term and long⁃term complicationsand prognosis. Results：The
surgical duration in the laparoscopic microwave ablation group was shorter than that in the laparoscopic surgery group（P < 0.001），the
intraoperative blood loss was lower than that in the laparoscopic surgery group（P < 0.001），and the postoperative hospital stay was
shorter than that in the laparoscopic surgery group（P < 0.001）. There were no significant difference in the incidence of postoperative
adverse reaction（P > 0.05），postoperative liver function on the first day after surgery（ALT，AST，TBIL，P > 0.05）between the two
groups. No midium ⁃ term or long ⁃ term complications were observedduring the follow ⁃ up period after surgery in both groups.
Conclusion：Laparoscopic microwave ablation is an effective and safe treatment for giant liverhemangioma，and it can significantly

［基金项目］ 国家自然科学基金（81972768）
∗
通信作者（Corresponding author），E⁃mail：wujindao@njmu.edu.cn