摘要
目的比较腹腔镜下肝部分切除术与传统开腹手术治疗原发性肝癌的疗效。方法根据手术方式的不同将159例原发性肝癌患者分为对照组(n=102)和观察组(n=57),对照组患者采取传统开腹手术,观察组患者采取腹腔镜下肝部分切除术。比较两组患者的手术相关指标、炎性因子[白细胞介素-2(IL-2)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)]水平、肝纤维化指标[Ⅲ型前胶原肽(PⅢP)、透明质酸(HA)、Ⅰ型前胶原羧基端前肽(PⅠCP)]及肝功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)]。结果观察组患者术中出血量明显少于对照组,手术时间明显长于对照组,切口长度和术后住院时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。术后1天,两组患者IL-2水平均低于本组术前,IL-6、TNF-α、PⅢP、HA、PⅠCP水平均高于本组术前,观察组患者IL-2水平高于对照组,IL-6、TNF-α、PⅢP、HA、PⅠCP水平均低于对照组,差异均有统计学意义(P﹤0.05)。术后1个月,两组患者ALT、AST水平均低于本组术前,观察组患者ALT、AST水平均低于对照组,差异均有统计学意义(P﹤0.05)。结论与传统开腹手术相比,腹腔镜下肝部分切除术治疗原发性肝癌可减少术中出血量,缩短住院时间,抑制炎症反应,延缓肝纤维化进程,有利于患者肝功能恢复。
Objective To compare the efficacy of laparoscopic partial hepatectomy and traditional open surgery in the treatment of primary liver cancer.Method A total of 159 patients with primary liver cancer were divided into control group(n=102)and observation group(n=57)according to different surgical methods.The patients in the control group un-derwent traditional open surgery,and the patients in the observation group underwent laparoscopic partial hepatectomy.The surgery-related indicators,inflammatory factor[interleukin-2(IL-2),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)]levels,liver fibrosis indexes[procollagen III peptide(PIIIP),hyaluronic acid(HA),the C-terminal of type I pro-peptide procollagen(PICP)]and liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST)]were compared between the two groups.Result The intraoperative bleeding volume of the observation group was significantly less than that of the control group,the operation time was significantly longer than that of the control group,and the incision length and postoperative hospitalization time were significantly shorter than those of the control group,and the differences were statistically significant(P<0.01).One day after the surgery,the IL-2 levels in both groups were lower than those before the surgery,and the levels of IL-6,TNF-α,PIIIP,HA,and PICP were higher than those be-fore the surgery,the level of IL-2 in the observation group was higher than that in the control group,and the levels of IL-6,TNF-α,PIIIP,HA,and PICP were lower than those in the control group,and the differences were statistically signifi-cant(P<0.05).One month after the surgery,the levels of ALT and AST in the two groups were lower than those before the surgery,and the levels ALT and AST in the observation group were lower than those in the control group,and the dif-ferences were statistically significant(P<0.05).Conclusion Laparoscopic partial hepatectomy for primary liver cancer could better reduce the amount of intraoperative bleeding,short
作者
杨彦伟
郑又侨
朱立峰
YANG Yanwei;ZHENG Youqiao;ZHU Lifeng(Department of Hepatobiliary Pancreatology and Spleen Surgery,Baoji Central Hospital,Baoji 721008,Shaanxi,China)
出处
《癌症进展》
2023年第22期2500-2503,共4页
Oncology Progress
基金
陕西省教育厅专项科研计划项目(20JK0687)。
关键词
原发性肝癌
腹腔镜下肝部分切除术
传统开腹手术
炎性因子
肝功能
primary liver cancer
laparoscopic partial hepatectomy
traditional open surgery
inflammatory factor
liver function
