文章摘要
梁裕团,戎祯祥,麦显强,等.腹腔镜肝癌根治术治疗原发性肝癌 30例[J].安徽医药,2019,23(11):2207-2210.
腹腔镜肝癌根治术治疗原发性肝癌 30例
Laparoscopic radical hepatectong for primany hepatocellular carcinoma an analysis of 30 cases
  
DOI:10.3969/j.issn.1009?6469.2019.11.022
中文关键词: 肝肿瘤  腹腔镜检查  剖腹术  生活质量  白细胞介素 6  白细胞介素 10  肿瘤坏死因子 α
英文关键词: Liver neoplasms  Laparoscopy  Laparotomy  Quality of life  Interleukin?6  Interleukin?10  Tumor necrosis factor?alpha
基金项目:
作者单位E-mail
梁裕团 佛山市顺德区新容奇医院普通外科广东佛山 528303  
戎祯祥 佛山市顺德区新容奇医院普通外科广东佛山 528303 82747292@qq.com 
麦显强 佛山市顺德区新容奇医院普通外科广东佛山 528303  
张少凌 佛山市顺德区新容奇医院普通外科广东佛山 528303  
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中文摘要:
      目的探讨腹腔镜肝癌根治术治疗原发性肝癌的效果及对炎性因子、纤维化相关因子水平的影响。方法选取 2016年 1月至 2017年 5月佛山市顺德区新容奇医院手术治疗的原发性肝癌病人 60例,其中 30例采用腹腔镜肝癌根治术治疗(腹腔镜组),另 30例接受传统开腹手术治疗(开腹组);对比两组的术中术后恢复情况、血清炎症介质及纤维化指标、病人的生活质量。结果腹腔镜组手术时间( 249.6±38.1)min长于开腹组(222.0±35.8)min(t=2.892,P=0.005)腹腔镜组手术出血量( 298.0± 55.6)mL、手术切口长度( 5.9±1.6)cm、住院时间( 7.3±1.6)d均低于开腹组[(410.4±86.5)mL24.1±3.8)cm、(12.5±2.8)d](t=-5.987、t=-24.177、t=-8.832,均 P=0.000);术后 1天,腹腔镜组 IL?6(11.83±1.85)pg/mL、IL?10(26.71±5.90)pg/mL、TNF?α、(4.78±1.83)ng/mL水平均低于开腹组[(13.78±2.26)pg/mL、(33.85±7.24)pg/mL、(5.92±2.00)ng/mL](t=-3.657、P=0.000, t=-4.187、P=0.000,t=-2.303,P=0.025)IL?2(4.20±1.14)高于开腹组3.52±1.09)μg/L(t=2.361,P=0.022),腹腔镜组 PⅢP(10.76±2.09)ng/L、HA(88.59±13.08)μg/LCⅠP(128.6±19.5)水平均低于开腹组[(12.48±2.75)ng/L、(101.63±16.71)μg/L、、P,(142.8±22.1)μg/L](t=-2.727、P=0.008,t=-3.366、P=0.001,t=-2.639,P=0.011);术后 3个月,腹腔镜组躯体功能( 52.1± 6.7)分、心理功能( 49.8±5.1)分、症状及副作用( 24.8±3.0)分、社会功能( 29.8±5.2)分及生存质量总分( 154.0±14.9)分高于开腹组[( 48.4±6.2)、(46.1±5.5)、(22.6±3.2)、(25.9±5.5)(145.0±15.2)分](t=2.220、P=0.030,t=2.702、P=0.009,t=2.747,P=0.008,t=2.822,P=0.007,t=2.316,P=0.024)。结论腹腔镜下肝癌切除治疗的优势在于创伤小、炎症反应轻、对血清纤维化指标影响小、有利于提高病人术后的生存质量。
英文摘要:
      Objective To investigate the effect of complete laparoscopic liver cancer resection and its effect on the patient’s quali? ty of life.Methods Sixty patients undergoing surgical treatment for primary liver cancer were selected for study.Thirty patients un?derwent complete laparoscopic surgery(laparoscopic group)and another 30 patients underwent traditional open surgery(open ab? dominal group).Intraoperative recovery,serum inflammatory mediators and fibrosis markers,and patient quality of life of the two groups were compared.Results The operation time of laparoscopic group was longer than that of laparotomy group[(249.6±38.1) min vs.(222.0±35.8)min,t=2.892,P=0.005].The amount of surgical bleeding[(298.0±55.6)mL vs.(410.4±86.5)mL],lengthof surgical incision[( 5.9±1.6)cm vs.(24.1±3.8)cm],and length of stay[( 7.3±1.6)d vs.(12.5±2.8)d]in laparoscopic group were lower than those in the open group(t=-5.987,t=-24.177,t=-8.832,all P values=0.000).One day after operation,the lev? els of IL?6[( 11.83±1.85)pg/mL vs.(13.78±2.26)pg/mL],IL?10[( 26.71±5.90)pg/mL vs.(33.85±7.24)pg/mL]and TNF?α[(4.78±1.83)ng/mL vs.(5.92±2.00)ng/mL]of the laparoscopic group were lower than those in the open group(t=-3.657,P= 0.000,t=-4.187,P=0.000,t=-2.303,P=0.025).IL?2 was higher than in the open group[(4.20±1.14)μg/L vs.(3.52±1.09)μg/L, t=2.361,P=0.022]and the levels of PIIIP[(10.76±2.09)ng/L vs.(12.48±2.75)ng/L],HA[(88.59±13.08)μg/L vs.(101.63± 16.71)μg/L],andPCI,P[( 128.6±19.5)μg/L vs.(142.8±22.1)μg/L]in the laparoscopic group lower than the open group(t= -2.727,P=0.008,t=-3.366,P=0.001,t=-2.639,P=0.011).3 months after surgery,laparoscopic group somatic function[(52.1± 6.7)vs.(48.4 ± 6.2)]psychological function[( 49.8 ± 5.1)vs.(46.1 ± 5.5)],symptoms and side effects[( 24.8 ± 3.0)vs.(22.6 ± 3.2)],social function[(2,9.8±5.2)vs.(25.9±5.5)]and quality of life total score[(154.0±14.9)vs.(145.0±15.2)]is higher than the open group(t=2.220,P=0.030,t=2.702,P=0.009,t=2.747,P=0.008,t=2.822,P=0.007,t=2.316,P=0.024).Conclusion The advantages of complete laparoscopic resection of liver cancer are less trauma,less inflammatory response,less influence on se? rum fibrosis indexes,and which beneficial to improve the quality of life of patients after surgery.
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