腹腔镜肝癌手术阻断第一肝门血流对患者免疫功能的影响  

Effects of hilar vascular occlusion on immune functions of patients undergoing liver cancer surgery under laparoscopy

作　　者：井红民 段红罡 郭永刚[1] 

机构地区：[1]平顶山市第一人民医院肝胆外科,河南省467000

出　　处：《江苏医药》2013年第17期2028-2030,共3页Jiangsu Medical Journal

摘　　要：目的探讨腹腔镜肝癌手术阻断第一肝门血流对患者免疫功能的影响。方法原发性肝癌患者168例采用三种术式:后腹腔镜肝脏切除,术中阻断第一肝门血流(A组,52例);腹腔镜肝脏切除,术中不阻断第一肝门血流(B组,56例);C组60例,开腹肝脏切除,术中阻断第一肝门血流。比较三组手术相关资料,检测治疗前后外周血单核细胞中CD4+细胞、CD8+细胞和自然杀伤(NK)细胞比例以及血清IL-2、IL-4和IFN-γ浓度。结果 A组和C组手术出血量显著少于B组(P<0.05)。A组住院时间显著短于B组和C组(P<0.05)。A组和C组ALT低于B组(P<0.05)。A组治疗前后外周血CD4+细胞、CD8+细胞和NK细胞比例以及血清IL-2、IL-4和IFN-γ浓度均无统计学差异(P>0.05);但B组和C组治疗后上述指标均明显低于治疗前(P<0.05)。结论后腹腔镜肝脏切除,术中阻断第一肝门血流,创伤小、出血少、较少影响肝功能和患者免疫功能。Objective To investigate the effects of hilar vascular occlusion（HVC） on immune functions of patients undergoing liver cancer surgery under laparoscopy. Methods A total of 168 patients with primary liver cancer was operated with three surgical methods, which were laparohepatoectomy with HVC （ group A, 52 cases）, laparohepatoectomy without HVC （ group B, 56 cases） and conventional openhepatoectomy with HVC（group C, 60 cases）. Data related to surgery including the proportion of CD4＋ , CD8＋ and NK cells in mononuclear cell of peripheral blood, and serum IL-2, IL-4 and IFN-y were compared. Results Surgical blood loss was less in groups of A and C than yhat in group B（P〈0. 05）. The hospital stay was shorter in group A than that in groups of B and C（P〈0. 05）. The percentages of CD4＋ , CD8＋ and NK cells in mononuclear cell of peripheral blood, and serum IL-2, IL-4 and IFN-7 were not significantly changed before and after surgery in group A（P〈0. 05）, which in groups of B and C were significantly lower after operation than those before（P〈0. 05）. Total bilirubin and transaminase relative value of group C were significantly higher than those of groups of A and group B（P〈0. 05）. Conclusion The laparohepatoectomy with HVC has the advantages of less injury, blood loss and influence on immune function in the patients with liver

关 键 词：肝门血流阻断 腹腔镜肝癌切除 免疫功能 

分 类 号：R735[医药卫生—肿瘤]