腹腔镜精准肝切除对原发性肝癌患者肝功能、免疫功能及炎性因子的影响

目的:探讨腹腔镜精准肝切除对原发性肝癌(PHC)患者肝功能、免疫功能及炎性因子的影响。方法:选取2013年2月~2018年12月期间我院收治的PHC患者117例,按随机数字表法分为对照组(n=58)和研究组(n=59),对照组给予开腹常规肝切除术治疗,研究组给予腹腔镜精准肝切除治疗。比较两组患者围术期指标、肝功能、免疫功能、炎性因子、并发症。结果:研究组术中出血量少于对照组,住院时间短于对照组(P<0.05);两组手术时间比较差异无统计学意义(P>0.05)。两组患者术后谷氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)均升高,但研究组低于对照组(P<0.05);两组患者术后白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平均升高,但研究组低于对照组(P<0.05);两组患者术后CD3^+、CD4^+、CD4^+/CD8^+均降低,但研究组高于对照组(P<0.05);CD8^+升高,但研究组低于对照组(P<0.05)。研究组术后并发症发生率低于对照组(P<0.05)。结论:腹腔镜精准肝切除治疗有助于保护PHC患者肝功能、免疫功能,改善炎性因子水平并减少术中出血量、住院时间,同时还可减少并发症发生率。

Effect of Laparoscopic Precise Hepatectomy on Liver Function, Immune Function and Inflammatory Factors in Patients with Primary Hepatocellular Carcinoma

Objective:To investigate the effect of laparoscopic precise hepatectomy on liver function,immune function and inflammatory factors in patients with primary hepatocellular carcinoma(PHC).Methods:117 patients with PHC who were admitted to our Hospital from February 2013 to December 2018 were randomly divided into control group(n=58)and study group(n=59).The control group was treated with routine open hepatectomy and the study group was treated with precise laparoscopic hepatectomy.Perioperative indexes,liver function,immune function,inflammatory factors and complications were compared between the two groups.Results:The amount of bleeding during operation in the study group was less than that in the control group,and the hospitalization time was shorter than that in the control group(P<0.05);there was no significant difference in the operation time between the two groups(P>0.05).The levels of glutamate aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL)increased in both groups,but the levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)in the study group were lower than those in the control group(P<0.05).The levels of CD3^+,CD4^+,CD4^+/CD8^+in the study group were lower than those in the control group(P<0.05),while the levels of CD8^+in the study group were higher than those in the control group(P<0.05),but the levels of CD8^+in the study group were lower than those in the control group(P<0.05).The incidence of postoperative complications in the study group was lower than that in the control group(P<0.05).Conclusion:Laparoscopic precise hepatectomy can protect the liver function and immune function of PHC patients,improve the level of inflammatory factors,reduce intraoperative bleeding and hospital stay,and reduce the incidence of complications.