Page 66 - 南京医科大学自然版

南京医科大学学报（自然科学版） 第45卷第5期
·652 · Journal of Nanjing Medical University（Natural Sciences） 2025年5月

·临床研究·

肝右后叶血管瘤腹腔镜下剥除术与解剖性切除术治疗的临床

疗效对比

蒋汉林，纽维桥，蒋宗赢，杨 光，吴建武，黄立宁，蒋新卫 *

南京医科大学附属苏州医院/苏州市立医院肝胆外科，江苏 苏州 215000

［摘 要］ 目的：比较肝右后叶血管瘤腹腔镜下剥除术与解剖性切除术两种术式处理肝血管瘤（hepatic hemangioma，HH）的近
期疗效。方法：选取2020年1月—2024年8月于南京医科大学附属苏州医院诊治的肝右后叶血管瘤患者58例，分为剥除术组
（28 例）和切除术组（30 例）。记录并比较两组患者的手术相关指标。结果：两组患者术前资料差异均无统计学意义（P 均>
0.05）。剥除术组在手术时长［（158.9±25.0）min］、术中出血量［（306.4±81.5）mL］和术后总引流量［（422.4±100.0）mL］上均优于
切除术组［（189.6±66.8）min、（378.8±154.5）mL、（732.5±318.0）mL，P < 0.05］。术后第1天，剥除术组的肝功能指标，血清天冬氨
酸转氨酶、丙氨酸氨基转移酶和总胆红素水平分别为（356.4±70.8）U/L、（369.1±22.2）U/L和（21.6±4.1）μmol/L，均显著低于切除
术组［（392.8±55.1）U/L、（405.5±35.9）U/L、（25.9±6.8）μmol/L，P < 0.05］；两组术后炎症指标和并发症总发生率差异均无统计学
意义（P均>0.05）。结论：肝右后叶血管瘤腹腔镜下剥除术与解剖性切除术均有效，但剥除术具有手术时间短、出血少、对肝功
能影响小的优势，临床手术方案应根据具体情况选择。
［关键词］ 肝右后叶；肝血管瘤；腹腔镜；血管瘤剥除术；肝切除术
［中图分类号］ R732.2 ［文献标志码］ A ［文章编号］ 1007⁃4368（2025）05⁃652⁃06
doi：10.7655/NYDXBNSN241200

Comparison of clinical efficacy between laparoscopic enucleation and anatomic resection
for right posterior lobe hepatic hemangiomas
JIANG Hanlin，NIU Weiqiao，JIANG Zongying，YANG Guang，WU Jianwu，HUANG Lining，JIANG Xinwei *
Department of Hepatobiliary Surgery，the Affiliated Suzhou Hospital of Nanjing Medical University/Suzhou Municipal
Hospital，Nanjing Medical University，Suzhou 215000，China

［Abstract］ Objective：To compare the short ⁃ term efficacy of laparoscopic enucleation versus anatomical resection for hepatic
hemangiomas（HH）in the right posterior lobe. Methods：A total of 58 patients with HH in the right posterior lobe from the Affiliated
Suzhou Hospital of Nanjing Medical University from January 2020 to August 2024 were selected，and divided into an enucleation group
（28 cases）and a resection group（30 cases）. Surgery⁃related indicators were recorded and compared between the two groups. Results：
There were no statistically significant differences in preoperative data between the two groups（all P >0.05）. The enucleation group had
better results in operation time（158.9±25.0）min，intraoperative blood loss（306.4±81.5）mL，and total postoperative drainage volume
（422.4±100.0）mL compared to the resection group［（189.6±66.8）min，（378.8±154.5）mL，（732.5±318.0）mL，all P < 0.05］. On the
first postoperative day，the liver function indexes of the enucleation group，including serum aspartate aminotransferase（AST），alanine
aminotransferase（ALT），and total bilirubin（TBIL）levels，were（356.4 ± 70.8）U/L，（369.1 ± 22.2）U/L，and（21.6 ± 4.1）μmol/L，
respectively，which were significantly lower than those of the resection group［（392.8±55.1）U/L，（405.5±35.9）U/L，（25.9±6.8）μmol/L，
P < 0.05］；there were no significant differences in postoperative inflammatory indicators or the total incidence of complications
between the two groups（all P > 0.05）. Conclusion：Both laparoscopic enucleation and anatomical resection are effective，but
enucleation has the advantages of shorter operation time，less bleeding，and less impact on liver function. The clinical surgical plan
should be selected according to the specific situation.
［基金项目］ 苏州市“科教兴卫”青年科技项目（KJXW2023040）；苏州市临床医学中心建设项目（Szlcyxzxj202107）；苏州市基
础研究计划⁃医学应用基础研究（SKYD2023141）
通信作者（Corresponding author），E⁃mail：jxw19681022@163.com（ORCID：0009⁃0001⁃4058⁃1255）
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