【摘要】 目的探讨胆囊癌早期患者采用腹腔镜胆囊切除术治疗的临床效果。方法选取2013年5月至2017年3月间西安医学院附属宝鸡医院收治的59例胆囊癌早期患者,按采用的手术方法不同分为观察组和对照组,其中,采用腹腔镜胆囊切除术治疗的30例患者纳入观察组,采用胆囊癌根治术治疗的29例患者纳入对照组。比较两组患者凝血功能变化、术后并发症情况、1年生存率及复发率。结果术前,两组患者活化部分凝血活酶时间(APTT)和D-二聚体水平比较,差异无统计学意义(P> 0. 05);术后24h,观察组APTT较对照组短,D-二聚体水平较对照组高,差异均有统计学意义(均P <0. 05)。观察组并发症发生率为6. 7%(2/30),低于对照组的31. 0%(9/29),差异有统计学意义(P <0. 05)。随访1年,观察组患者1年生存率为86. 7%,对照组患者1年生存率为93. 1%,两组患者生存率比较,差异无统计学意义(P> 0. 05)。随访1年,观察组复发率10. 0%(3/30),对照组为6. 9%(2/29),两组患者复发率比较,差异无统计学意义(P> 0. 05)。结论胆囊癌早期患者采用腹腔镜胆囊切除术治疗能降低并发症发生率,且不影响预后,但术后血栓发生风险高,围术期需给予防范性措施。更多还原

【Abstract】 Objective To study the clinical efficacy of laparoscopic cholecystectomy for the early stage of gallbladder cancer. Methods From May 2013 to March 2017,59 patients with early gallbladder cancer treated at Baoji Hospital of Xi’an Medical College were selected and divided into an observation group( 30 patients) and a control group( 29 patients) according to different operative methods. The observation group underwent laparoscopic cholecystectomy and the control group underwent radical cholecystectomy. The changes in coagulation function,postoperative complications and 1-year survival and recurrence were compared between the two groups. Results Before the treatment,there was no significant difference in activated partial thromboplastin time( APTT) and D-dimer level between the two groups( all P > 0. 05). However,at 24 h after the surgery,APTT was shorter in the observation group than in the control group and the D-dimer level was higher in the observation group than in the control group( P < 0. 05). The incidence of complications was 6. 7%( 2/30) in the observation group which was lower than 31. 0%( 9/29) of the control group( P < 0. 05). The 1-year survival rate was 86. 7% in the observation group and 93. 1% in the control group during the follow-up of 1 year. The recurrence rate was 10% 10. 0%( 3/30) in the observation group and 6. 9%( 2/29) in the control group( P > 0. 05). Conclusion Laparoscopic cholecystectomy for the early stage of gallbladder cancer can reduce the incidence of complications without affecting the prognosis,but the risk of postoperative thrombosis is high,and preventive measures should be given during the perioperative period.更多还原