腹腔镜与开腹手术治疗肝囊肿的疗效与安全性分析

郑海明

[摘要] 目的 对肝囊肿患者应用腹腔镜手术和开腹手术进行治疗并对其疗效及安全性进行分析研究。方法 方便选择2017年6月—2019年4月间到该院就诊的100例肝囊肿患者作为研究对象，根据手术方案给予的不同将100例患者分为腹腔组和开腹组，每组50例，采用腹腔镜下小切口术对腹腔组患者进行治疗，采用传统开腹手术对开腹组患者进行治疗。对腹腔组和开腹组患者的手术情况、术后并发症以及肝功能指标情況进行分析比较。 结果 在术中出血量、胃肠功能恢复时间、手术时间以及住院时间上，腹腔组情况均好于开腹组，差异有统计学意义（术中出血量t=27.693，P=0.000;胃肠功能恢复时间t=20.416，P=0.000;手术时间t=24.691，P=0.000;住院时间t=18.607，P=0.000）;腹腔组出现切口感染、胆瘘、腹水等并发症共2例，发生率为4.00%，开腹组出现共8例，发生率为16.00%，腹腔组明显低于开腹组，组间比较差异有统计学意义（χ2=4.000，P=0.046）;治疗后，腹腔组患者的TBil、DBil、AST以及ALT等肝功能指标均高于开腹组，差异有统计学意义（t=8.320，P=0.000;t=18.694，P=0.000;t=2.362，P=0.020;t=3.391，P=0.001）。结论 相比较传统开腹术，对肝囊肿患者应用腹腔镜下小切口术进行治疗，可以明显改善患者的术中情况及肝功能水平，并减小并发症的发生率，安全有效。

[关键词] 肝囊肿;腹腔镜;开腹手术;安全性;疗效

[Abstract] Objective To treat patients with liver cysts by laparoscopy and laparotomy， and analyze their efficacy and safety. Methods A total of 100 patients with liver cysts who visited the hospital from June 2017 to April 2019 were selected as the research subjects. According to the different surgical schemes， 100 patients were convenient divided into the abdominal cavity group and the open abdominal group， 50 in each group. A small laparoscopic incision was used to treat patients in the abdominal cavity group， and a traditional open surgery was used to treat patients in the abdominal group. The surgical conditions， postoperative complications， and liver function parameters of the patients in the abdominal and open groups were analyzed and compared. Results In terms of intraoperative blood loss， recovery time of gastrointestinal function， operation time and hospitalization time， the condition of the abdominal cavity group was better than that of the open group，and the difference was statistically significant （intraoperative blood loss t=27.693，P=0.000; recovery time of gastrointestinal function t=20.416， P=0.000; operation time t=24.691， P=0.000; hospitalization time t=18.607， P= 0.000） ; incision infection， biliary fistula， 2 cases of complications such as ascites， with an incidence rate of 4.00%. A total of 8 cases appeared in the open group， the incidence rate was 16.00%. The abdominal group was significantly lower than the open group，and the difference was statistically significant; after treatment， patients in the abdominal group had TBil， DBil， AST， and ALT and other liver function indexes were higher than those of the open abdominal group， and the differences were statistically significant（χ2=4.000， P=0.046;t=8.320，P=0.000;t=18.694，P=0.000;t=2.362，P=0.020;t=3.391，P=0.001）.Conclusion Compared with traditional laparotomy， the treatment of patients with hepatic cysts by laparoscopic small incision can significantly improve the intraoperative situation and liver function level of patients， and reduce the incidence of complications. It is safe and effective.