Objective:To investigate the efficacy of indocyanine green（ICG）fluorescence imaging in hepatectomy of complex and difficult hepatocellular carcinoma（HCC）.Methods:A total of 80 HCC patients who underwent complex and difficult hepatectomy from January 2018 to October 2022 were retrospectively selected as subjects. According to different tumor localization and hepatectomy plane determination scheme，the patients were divided into conventional group and ICG fluorescence group，with 40 cases in each group. Conventional group：Routine laparoscopic hepatectomy（LH）；ICG fluorescence group：LH was completed under the guidance of ICG fluorescence development. Data was processed by SPSS 22.0. Perioperative relevant indicators，liver function indicators and other measurement data were represented by（xˉ±s），independent t test；Statistical data such as postoperative complications were represented by［cases（%）］，χ2 test was performed. P<0.05 was considered statistically significant.Results:Operation time，intraoperative blood loss，hilar occlusion time and postoperative hospital stay in ICG fluorescence group were significantly lower than those in conventional group，and R0 margin rate was significantly higher than that in conventional group，with statistical significance（P<0.05）. There was no significant difference in postoperative anal exhaust time，postoperative extubation time and postoperative complication incidence between the two groups（P>0.05）. There was no interaction between time and method at the levels of ALB，TBIL，AST and ALT（P>0.05），while the main effect of time and method was significant at the levels of ALB，TBIL，AST and ALT（P<0.05）.Conclusion:The application of ICG fluorescence imaging in hepatectomy of complex and difficult hepatocellular carcinoma is safe and effective. It can not only effectively shorten the operation time and hilar occlusion time，reduce intraoperative injury and improve R0 resection rate，but also benefit the postoperative recovery of patients and the recovery of liver function，which is worthy of widespread clinical application.

目的 研究比较使用手术切除与射频消融两种不同的医疗方法对治疗3～6cm的单发性肝癌的疗效,为患者的手术治疗提供指导.方法 选取2016年3月至2018年6月玉林市第一人民医院治疗3～6cm单发性肝癌的患者180例的诊疗情况.按照治疗方式,分为射频组和手术组.其中采用手术组的患者80例,射频组的患者100例,比较分析两种治疗方式的在疗效上的差异.结果 射频组术后6个月内复发率为32.30％,12个月内复发率为70.77％,24个月内复发率为90.76％,手术组术后6个月内复发率为25.00％,12个月以内复发率为62.50％,24个月以内复发率为82.50％,两组同时间段内的复发率比较,差异有统计学意义(P＜0.05);射频组存活率第6、12、24个月内分别为85.38％、71.15％、53.71％.手术组存活率分别为84.58％、69.58％、55.00％,两组在相同时间段内的存活率比较,差异无统计学意义(P＞0.05);两组大致肝功能预后情况相同,差异无统计学意义(P＞0.05).结论 对于治疗大小为3～6cm的单发性肝癌,手术切除可作为临床首选的治疗方式.

目的 探讨一次性水冷不粘双极电凝在肝切除中的应用效果.方法 选取122例行择期肝切除的原发性肝癌(PHC)患者为研究对象,采用随机数字表法分为观察组和对照组,每组61例.观察组术中使用一次性水冷不粘双极电凝,对照组使用常规单极电凝.记录两组手术相关指标(手术时间、术中出血量、术中输血例数、住院时间)、住院期间并发症(腹水、胆漏、低蛋白血症、腹腔感染等)发生情况及两组术前、术后3d肝功能指标,如白蛋白(ALB)、谷丙转氨酶(ALT)变化情况.结果 观察组手术时间长于对照组,术中出血量、术中输血例数、住院时间均少于对照组,差异均有统计学意义(P＜0.05).与术前比较,术后两组ALB明显降低,ALT水平明显升高;且术后观察组血清ALB水平高于对照组,ALT水平低于对照组,差异均有统计学意义(P＜0.05).观察组住院期间并发症总发生率明显低于对照组,差异有统计学意义(P＜0.05).结论 一次性水冷不粘双极电凝在肝切除术中的应用效果显著,可减少术中出血量,并控制输血比例,且能降低肝功能损伤程度,有利于患者预后.

Objective To investigate the Glisson pedicle be dealt with hepatic resection feasibility and clinical control in HCC resection. Methods In August 2006 to August 2013 in Yulin city of Guangxi in the first hospital of liver cancer pa-tients were randomly selected in 92 cases, according to the random number table method respectively in the test group (Glissonean pedicle in conjunction with the treatment method for liver resection, n = 46) and control group (Pringle hepate-ctomy, n = 46). The operation time, blood loss, liver function index, complication rate and recurrence rate were compared between the two groups. Results Two groups of patients with operation time no significant difference (P> 0.05); bleeding during operation in both groups, the indexes of liver function, complications occurrence rate compared with statistical signif-icance (P< 0.05); and were followed up for 1 year after operation, experimental group, control group, the recurrence rate was 4.3%, 21.7% (P< 0.05). Conclusion Glisson pedicle be dealt with hepatic resection in hepatocellular carcinoma re-section application, and can obtain more Pringle maneuver hepatectomy more significant effect should be further research and extension.

目的探讨应用腋窝入路腔镜甲状腺肿瘤切除术对患有甲状腺肿瘤的患者实施治疗的临床效果。方法抽取86例患有甲状腺肿瘤的患者,随机分为对照组和治疗组,每组43例。采用常规开放手术方式对对照组患者实施治疗;采用腋窝入路腔镜甲状腺肿瘤切除术对治疗组患者实施治疗。结果治疗组治疗有效率高于对照组(P<0.05);手术操作时间和术后住院时间明显短于对照组(P<0.05);术中出血量明显少于对照组(P<0.05);围手术期不良反应率明显低于对照组(P<0.05)。结论应用腋窝入路腔镜甲状腺肿瘤切除术对患有甲状腺肿瘤的患者实施治疗的临床效果非常明显。

目的:分析对肝内胆管结石合并有肝胆管癌患者进行外科手术的效果如何。方法:选择68例肝内胆管结石合并有肝胆管癌的患者,对其进行外科手术治疗,然后观察手术效果和术后并发症情况。结果:患者1年生存率是67.65%,3年生存率是30.88%,有1例死亡。结论:要警惕肝内胆管结石患者合并有肝胆管癌,要想提高疗效那么就要早诊断、早治疗,进行根治性手术。

目的对应用胃部分切除术对患有早期胃癌的患者实施治疗的临床效果进行研究。方法抽取86例患有早期胃癌的患者,随机分为对照组和治疗组,平均每组43例。采用常规胃癌根治术对对照组患者实施治疗;采用胃部分切除术对治疗组患者实施治疗。结果治疗组患者早期胃癌症状治疗效果明显优于对照组;BMI指数明显高于对照组;通气时间和胃排空时间明显短于对照组;围手术期不良反应和治疗后病情复发人数明显少于对照组。结论应用胃部分切除术对患有早期胃癌的患者实施治疗的临床效果非常明显。

Objective To explore the best surgery treatment of the acute biliary pancreatitis.Methods 85 cases of patients with the acute biliary pancreatitis were selected and divided into the surgical laparoscopy(experimental group) and classical treatment(control group)by the treatment methods.To analyze the complement clinical data of the two group with retrospective ways,time of serum amylase recovery,time of abdominal pain release,duration of remission,the incidence of complications,hospital stay and mortality were contrasted between experimental group and control group.Results The experimental group was significantly lower than the control group in the recovery time of blood amylase,abdominal pain relief time and hospitalization time,there was significant difference between the two groups(P 0.05);the experimental group was significantly lower than the control group in the incidence of complications,the difference between the two groups was statistically significant(P 0.05);the experimental group was significantly lower than the control group in the mortality(P 0.05).Conclusion In the early stage,laparoscopic treatment could significantly shorten the time of the related indicators of the obstructive acute biliary pancreatitis returned to normal,and significantly reduce the mortality and incidence of complications.