摘要
目的探讨腹腔镜下左半肝切除术与恩度联合治疗肝癌(HCC)的效果及其对患者血清高迁移率族蛋白B1(HMGB1)和胸苷激酶1(TK1)表达水平的影响。方法回顾性分析2012年7月至2016年1月在山东大学齐鲁医院行手术治疗的86例HCC患者作为研究对象,按照治疗方法将其分为对照组(n=43)和联合组(n=43)。所有患者均行腹腔镜下左半肝切除术,联合组患者同时给予恩度治疗。观察并比较两组患者的围手术期指标(手术时间、术中出血量、术后ICU时间、胃肠功能恢复时间、术后腹腔引流时间、住院时间),围手术期并发症发生情况(肺部感染、腹腔或胸腔积液、胆漏、肝功能衰竭、肾功能不全、腹腔内出血等),术后生存时间,无瘤生存时间,术后1年肿瘤复发率;应用酶联免疫吸附试验(ELISA)和免疫印迹增强化学发光法检测两组患者用药前、手术前,以及手术后1个月、6个月、12个月时的血清HMGB1、TK1水平。结果①对照组与联合组患者手术时间(3. 13±1. 04 h vs. 3. 08±1. 12 h)、术中出血量(257. 2±233. 9 ml vs. 261. 5±219. 1 ml)、术后ICU时间(1. 92±0. 56 d vs. 1. 88±0. 60 d)、胃肠功能恢复时间(1. 94±0. 59 d vs. 1. 90±0. 63 d)、术后腹腔引流时间(3. 37±1. 26 d vs. 3. 29±1. 41 d)和住院时间(9. 06±2. 23 d vs. 8. 85±2. 36 d)等围手术期指标比较差异均无统计学意义(P> 0. 05),两组患者围手术期并发症发生率比较差异也无统计学意义(P> 0. 05)。②联合组患者术后平均生存时间(124. 50±9. 12周)、无瘤平均生存时间(117. 26±9. 15周)均明显长于对照组(114. 83±7. 45周,102. 57±7. 09周),其术后1年肿瘤复发率(34. 88%)也显著低于对照组(58. 14%),差异均具有统计学意义(P <0. 05)。③用药前对照组与联合组患者血清HMGB1、TK1水平比较差异均无统计学意义(P> 0. 05),联合组患者手术前和手术后较用药前均明显降低,且联合组患者手术前,以及手术后1个月、6�
Objective To explore the effect of laparoscopic left hemihepatectomy and application of endostar on hepatocellular carcinoma (HCC) and its effect on expression of high mobility group protein B1 (HMGB1) and thymidine kinase 1 (TK1). Methods A retrospective analysis was made in eighty-six patients with HCC in Qilu Hospital of Shandong University during July 2012 to January 2016, they were divided into 2 groups, 43 cases in control group and 43 cases in combination group according to the treatment methods. All these patients underwent laparoscopic left hemihepatectomy, while patients in the combination group received Endostar treatment. The indices of perioperative period (operating time, volume of intraoperative bleeding, duration for postoperative stay in ICU, gastrointestinal function recovery time, duration for postoperative abdominal drainage, duration for hospitalization, perioperative complications (pulmonary infection, peritoneal or pleural effusion, bile leakage, liver failure, renal failure, renal insufficiency, abdominal cavity, and intraperitoneal bleeding etc.), postoperative survival time, tumor free survival time, and recurrent rate of tumor in 1 years after operation were observed and compared between these two groups, the serum levels of HMGB1 and TK were detected before medication, before operation and 1 month, 6 months and 12 months after operation by using enzyme linked immunosorbent assay (ELISA) and immunoblotting enhanced chemiluminescence detection. Results ①There was no significant difference between patients in control group and combination group, such as the operating time (3.13±1.04 h vs. 3.08±1.12 h), the amount of bleeding (257.2±233.9 ml vs. 261.5±219.1 ml), the duration in ICU (1.92±0.56 d vs. 1.88±0.60 d), the recovery time of gastrointestinal function (1.94±0.59 d vs. 1.90±0.63 d), the duration of postoperative abdominal drainage (3.37±1.26 d vs. 3.29±1.41 d) and the duration of hospitalization (9.06±2.23 d vs. 8.85±2.36 d)( P >0.05), and there was no statistical diffe
作者
杜刚
王永利
冯雅
DU Gang;WANG Yong-li;FENG Ya(Department of Hepatobiliary Surgery,Qilu Hospital of Shandong University,Jinan Shandong 250012,China.)
出处
《临床和实验医学杂志》
2019年第17期1874-1879,共6页
Journal of Clinical and Experimental Medicine
基金
山东省科研基金项目(编号:SD20173654-12)
关键词
肝癌
腹腔镜肝切除术
恩度
治疗效果
血清高迁移率组蛋白B1
血清胸苷激酶1
Hepatocellular carcinoma
Laparoscopic hepatectomy
Endostar
Therapeutic effect
Serum high mobility histone B1
Serum thymidine kinase 1
