王 帅,杨寒冰,邵 玥,严东语,春 花

目的：比较高海拔地区肝癌患者腹腔镜手术与开腹手术的疗效，探讨SpO2及术前肺部合并症对恢复的影响。方法：回顾性分析2023—2025年西藏某院肝切除64例（腹腔镜33例、开腹31例），记录术后24 h最低SpO2，<90%为低氧，分析术前肺部合并症对预后的影响。结果：腹腔镜出血更少、住院更短。低氧者住院时间延长（16 d vs 12 d）。高原本身降低SpO2，合并慢阻肺、肺气肿等术前肺部基础病者SpO2更低、预后更差。结论：高海拔肝切除中腹腔镜更利于康复；术后早期SpO2及术前肺部合并症是重要预后因素。

肝细胞癌；腹腔镜手术；开腹手术；SpO2；影响因素

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