| 摘要: |
| ［摘要］ 目的 分析Glisson蒂横断式肝切除术在小儿肝脏肿瘤手术中的应用效果。方法 回顾性分析2019年10月至2022年10月山西省儿童医院普外科收治的18例原发性肝脏肿瘤患儿的临床资料，对治疗结果及患者预后进行总结分析。结果 18例患儿均通过Glisson蒂横断式肝切除术成功行相应的肝段或肝叶切除，均未发生围术期死亡，手术时间为(204.52±46.84)min，术中出血量为(245.73±56.86)ml，术中输血量为(200.84±50.57)ml。与术前相比，患儿术后1周血小板(PLT)和总胆汁酸(TB)水平降低，差异有统计学意义（P<0.05）。白细胞(WBC)、红细胞(RBC)、血红蛋白(Hb)、甲胎蛋白(AFP)、白蛋白(ALB)、谷草转氨酶(AST)、谷丙转氨酶(ALT)和乳酸脱氢酶(LDH)等指标在手术前后比较差异无统计学意义（P>0.05）。7例肝母细胞瘤患儿术后血清AFP较术前显著升高［234.00(44.00，550.00) vs 140.00(23.00，495.00)；Z=4.846，P=0.018］。截至2023年6月，10例良性肝肿瘤患儿生长发育正常，均未复发，生存率为100%；8例恶性肝肿瘤患儿中，1例肝母细胞瘤患儿在术后6个月复发，予C5VD方案化疗3个疗程，复查腹部CT示肿瘤体积明显缩小，其余7例术后未复发。结论 Glisson蒂横断式肝切除术治疗小儿原发性肝脏肿瘤安全、有效。 |
| 关键词: 小儿患者 原发性肝脏肿瘤 Glisson蒂横断式肝切除术 临床效果 |
| DOI：10.3969/j.issn.1674-3806.2023.11.09 |
| 分类号:R 735.7 |
| 基金项目:山西省重点研发计划项目（编号：201903D321159） |
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| Analysis on the application effect of Glisson tip transected hepatectomy in paediatric liver tumour surgery |
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CHEN Jin-yu, XI Hong-wei
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Department of Paediatric Medicine, Shanxi Medical University, Taiyuan 030000, China
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| Abstract: |
| ［Abstract］ Objective To analyze the application effect of Glisson tip transected hepatectomy in paediatric liver tumour surgery. Methods The clinical data of 18 paediatric patients with primary liver tumour who were admitted to the Department of General Surgery of Shanxi Children′s Hospital from October 2019 to October 2022 were retrospectively analyzed, and the treatment results and prognosis of the patients were summarized and analyzed. Results The 18 paediatric patients underwent the corresponding hepatic segmentectomy or liver lobectomy successfully by using Glisson tip transected hepatectomy, and no perioperative deaths occurred. The operative time was (204.52±46.84)min, and the intraoperative blood loss was (245.73±56.86)ml, and the intraoperative blood transfusion volume was (200.84±50.57)ml. The levels of platelets(PLT) and total bile acid(TB) of the paediatric patients were decreased 1 week after surgery compared with those before surgery, and the differences were statistically significant(P<0.05). There were no significant differences in white blood cells(WBC), red blood cells(RBC), haemoglobin(Hb), alpha-fetoprotein(AFP), albumin(ALB), aspartate aminotransferase(AST), alanine aminotransferase(ALT) and lactate dehydrogenase(LDH) before and after operation(P>0.05). The postoperative serum AFP levels of 7 paediatric patients with hepatoblastoma were significantly higher than their preoperative AFP levels ［234.00(44.00, 550.00) vs 140.00(23.00, 495.00); Z=4.846, P=0.018］. By June 2023, the growth and development of 10 paediatric patients with benign liver tumors were normal, and no recurrence occurred, with a survival rate of 100%. Among the 8 paediatric patients with malignant liver tumors, 1 case with hepatoblastoma recurred 6 months after surgery and was treated with C5VD chemotherapy for 3 courses, and abdominal computed tomography(CT) examination showed a significant reduction in tumor volume. There was no recurrence in the other 7 cases. Conclusion Glisson tip transected hepatectomy is safe and effective in the treatment of primary liver tumors in paediatric patients. |
| Key words: Paediatric patient Primary liver tumour Glisson tip transected hepatectomy Clinical effect |
