摘要
目的探讨腹腔镜肝切除术联合微波固化治疗肝肿瘤的效果及对免疫功能的影响。方法选取2017年5月至2019年3月间兵器工业卫生研究所收治的接受手术治疗的84例肝肿瘤患者的临床资料进行回顾性分析,根据治疗方式不同进行分组,其中,采用腹腔镜肝切除术联合微波固化治疗的44例患者纳入观察者,采用腹腔镜肝切除术治疗的40例患者纳入对照组。比较两组患者的围手术期情况、应激反应、免疫功能及临床疗效。结果两组患者的住院时间、手术时间、引流管留置时间及并发症发生率比较,差异无统计学意义(P>0.05)。观察组患者术中出血量低于对照组,差异有统计学意义(P<0.05)。术前,两组患者的白细胞介素-6(IL-6)、C-反应蛋白(CRP)和血清肿瘤坏死因子-α(TNF-α)等应激反应指标比较,差异无统计学意义(P>0.05)。术后3d,两组患者的IL-6、CRP和TNF-α均高于术前,且观察组均低于对照组,差异均有统计学意义(均P<0.05)。术前,两组患者的CD3^+、CD4^+/CD8^+和自然杀伤细胞(NK)水平比较,差异无统计学意义(P>0.05)。术后3d,两组患者的CD3^+、CD4^+/CD8^+和NK水平低于术前,且观察组均高于对照组,差异均有统计学意义(均P<0.05)。观察组患者临床治疗总有效率为93.2%,均高于对照组的75.0%,差异有统计学意义(P<0.05)。结论腹腔镜肝切除术联合微波固化治疗肝肿瘤的效果确切,术后并发症少,对免疫功能影响较小,值得临床推广应用。
Objective To investigate the efficacy of laparoscopic hepatectomy combined with microwave coagulation in the treatment of liver tumors and its effect on immune function.Methods The clinical data of 84 patients with liver tumors treated surgically at Shaanxi Ordnance Industry Institute of Health from May 2017 to March 2019 were selected and retrospectively analyzed.Based on the different treatment methods,they were divided into an observation group in which patients received laparoscopic hepatectomy combined with microwave coagulation(44 patients)and a control group in which patients only received laparoscopic hepatectomy(40 patients).The perioperative conditions,stress response,immune function and clinical efficacy were compared between the two groups.Results There was no significant difference in length of hospital stay,operation time,drainage tube indwelling time,and operation-associated complicaitons between the two groups(P>0.05).Haemorrhagia amount during the operation was was significantly lower in the observation group than in the control group(P<0.05).There was no significant difference in the levels of stress response indicators indluding interluekin-6(IL-6),C-reactive protein(CRP)and tumor necrosis factor-a(TNF-a)between the two groups before the operation(P>0.05).At 3 d after the operation,the levels of IL-6,CRP and TNF-a were higher in the two groups than before the operation,and the observation group was significantly lower than in the control group(all P<0.05).Before the operation,there was no significant difference in the levels of CD3^+,CD4^+/CD8^+and natural killer(NK)cells between the two groups(P>0.05).At 3 d after the operation,the levels of CD3^+,CD4^+/CD8^+and NK were lower in the two groups than before the operation,and the levels were significantly higher in the observation group than in the control group(all P<0.05).The overall efficacy rate was 93.1%in the observation group which was significantly higher than 75.0%of the control group(P<0.05).Conclusion Laparoscopic hepatectomy combined
作者
万涵
郭庆
王维
WAN Han;GUO Qing;WANG Wei(Department of Hepatobiliary and Vascular Surgery,Shaanxi Ordnance Industry Institute of Health,Xi’an 710043,China;Department of Urology Surgery,Xi’an North Hospital,Xi’an 710043,China;Department of geriatrics,Xi’an North Hospital,Xi’an 710043,China)
出处
《中国肿瘤临床与康复》
2020年第6期715-718,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
肝肿瘤
腹腔镜肝切除术
微波固化
免疫功能
效果
Liver neoplasms
Laparoscopic hepatectomy
Microwave coagulation
Immune function
Effectiveness
