摘要
【目的】探讨腹腔镜辅助联合肝脏离断和门静脉结扎二步肝切除术(ALPPS)一期手术治疗原发性肝癌(PLC)效果及对微小RNA-145(miR-145)、miR-143、免疫指标水平的影响。【方法】选取2017年4月至2020年5月本院收治的63例PLC患者,根据手术方式的不同将其分为观察组(腹腔镜辅助ALPPS术,n=32)和对照组(开腹ALPPS术,n=31)。对比两组患者手术情况、并发症发生情况。比较两组术前、术后3 d血清体液免疫功能指标[免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)]、肝功能指标[丙氨酸氨基转移酶(ALT)、冬氨酸氨基转移酶(AST)、总胆红素(TBil)]。比较两组术前、术后3 d、1周miR-145、miR-143水平。【结果】观察组术后排气时间、住院时间较对照组短,术中出血量较对照组低,差异有统计学意义(P<0.05)。观察组术后并发症发生率为12.50%(4/32),低于对照组的29.03(9/31),但差异无统计学意义(χ2=2.628,P=0.105>0.05)。两组患者术后3 d血清IgM、IgA、IgG水平较术前下降,但观察组高于对照组,差异有统计学意义(P<0.05);血清ALT、AST、TBil水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05)。两组患者术后3 d、1周血清miR-145、miR-143水平较术前降低,且观察镜组低于对照组,差异有统计学意义(P<0.05)。【结论】腹腔镜辅助ALPPS一期手术治疗PLC患者,具有创伤小、出血少、术后恢复快等优势,可保护肝功能,减轻免疫功能损伤,降低血清miR-145、miR-143表达。
【Objective】To investigate the effect of laparoscopic assisted ALPPS(associating liver partition and portal vein ligation for staged hepatectomy)one-stage surgery in the treatment of primary liver cancer (PLC) and its influence on the levels of microrna-145 (miR-145), miR-143 and immune indexes. 【Methods】 A total of 63 PLC patients from April 2017 to may 2020 in our hospital were selected and divided into observation group (laparoscopic assisted AlPPS,n=32) and control group (open AlPPS,n=31). The operation and complications of the two groups were compared. The serum humoral immune function indexes (immunoglobulin M (IgM), immunoglobulin A (IGA), immunoglobulin G (IgG)) and liver function indexes (alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBiL) were compared between the two groups before and 3 days after operation. The levels of miR-145 and miR-143 were compared between the two groups before operation, 3 days and 1 week after operation. 【Results】The postoperative exhaust time, hospital stay and intraoperative blood loss of the observation group were shorter than those of the control group, and the difference was statistically significant (P<0.05). The incidence of postoperative complications in the observation group was 12.50% (4/32), which was lower than 29.03 (9/31) in the control group, but the difference was not statistically significant (χ2=2.628, P=0.105>0.05). The levels of serum IgM, IgA and IgG in the two groups were lower than those before operation, but the observation group was higher than the control group, the difference was statistically significant (P<0.05);the serum ALT, AST, TBiL levels were higher than those before operation, but the observation group was lower than the control group, the difference was statistically significant (P<0.05). The serum levels of miR-145 and miR-143 in the observation group were lower than those in the control group 3 days and 1 week after operation, and the difference was statistically significant (P<0.05). 【Co
作者
赵婧萱
孙新儒
赵娜
ZHAO Jing-xuan;SUN Xin-ru;ZHAO Na(Yangling Demonstration Zone Hospital,Shanxi 712100)
出处
《医学临床研究》
CAS
2020年第12期1824-1827,共4页
Journal of Clinical Research
