腹腔镜肝癌切除术效果及其对患者血清淋巴细胞亚群、炎症因子水平的影响  

Result of laparoscopic hepatectomy and its effect on serum lymphocyte subsets and inflammatory factors

作　　者：李树营 曹子谦 任宏[3] 刘海珠 Li Shuying;Cao Ziqian;Ren Hong(Department of General Surgery,First Hospital of Yulin City in Shaanxi Province,Yulin 718000)

机构地区：[1]陕西省榆林市第一医院普外科,榆林718000 [2]陕西省榆林市横山区人民医院普外科,榆林719100 [3]西安交通大学第一附属医院肿瘤外科,西安710061

出　　处：《陕西医学杂志》2018年第11期1390-1393,共4页Shaanxi Medical Journal

摘　　要：目的:探讨腹腔镜下肝癌左外叶切除术对患者术后疼痛、住院时间和淋巴细胞亚群、炎症因子水平的影响。方法:将79例行肝癌左外叶切除术的患者作为研究对象,其中采取开腹手术者25例为开腹组,54例采取腹腔镜手术者为腹腔镜组。比较两组手术相关指标(术中出血量、手术时间、住院天数、术后镇痛药物使用时间)、炎症因子(肿瘤坏死因子-!、白介素-8、C反应蛋白)、淋巴细胞亚群(CD_3、CD_4/CD_8、CD_(19))等指标的差异。结果:腹腔镜组术中出血量、手术时间、住院天数、术后镇痛药物使用时间较开腹组均显著下降/缩短(均P<0.05)。腹腔镜组术后炎症因子的水平较开腹组均显著降低,而开腹组术后各炎症因子的水平较术前均显著升高(均P<0.05)。两组术后淋巴细胞亚群(CD_3、CD_4/CD_8、CD_(19))的水平较术前均显著降低,且腹腔镜组术后各指标的水平较开腹组均显著升高(均P<0.05)。结论:腹腔镜下肝癌左外叶切除术可有效减轻患者术后疼痛,减轻手术创伤,且能够明显改善术后炎症反应,减弱免疫功能的影响,进而能够加快患者术后早日康复。Objective To analyze the effect of laparoscopic left lateral lobectomy of hepatocellular carcinoma on postoperative pain, time of hospitalization, lymphocyte subsets, and inflammatory factors. Methods： 79 cases of laparoscopic left lateral lobectomy of hepatocellular carcinoma treated in our hospital were taken as research subjects, of which 25 were open laparotomy group and 54 cases were laparoscopy group. The two groups of surgical related indexes （intraoperative bleeding volume, operation time, hospital days, the time of postoperative analgesic drug used）, inflammatory factors （tumor necrosis factor-0x0E？SymbolaA@0x0F, interleukin-8, C-reactive protein）, lymphocyte subgroups （CD 3 , CD 4 /CD 8 , CD 19 ） were compared. Results： The amount of bleeding, the time of operation, the days of hospitalization and the time of postoperative analgesic drug used in the laparoscopy group were significantly lower than those in the open laparotomy group （all P 〈0.05）. The levels of inflammatory factors in the laparoscopy group were significantly lower than those in the laparotomy group, but the levels of the inflammatory factors in the laparotomy group were significantly higher than those before the operation （all P 〈0.05）. The levels of lymphocyte subgroups （CD 3 , CD 4 /CD 8 , CD 19 ） in the two groups were significantly lower than those before the operation, and the levels of those indexes in the laparoscopy group was significantly higher than that in the open laparotomy group （all P 〈0.05）. Conclusion： Laparoscopic left external resection of hepatocellular carcinoma can effectively reduce postoperative pain and reduce the surgical trauma, and can obviously improve the postoperative inflammatory response, weaken the influence of immune function, and then accelerate the recovery of the patients after operation, so it has good clinical value.

关 键 词：肝肿瘤/外科学 腹腔镜检查/方法 淋巴细胞亚群 炎症因子 免疫功能 

分 类 号：R735.7[医药卫生—肿瘤]