腹腔镜肝切除术对原发性肝癌患者免疫球蛋白及VEGF aFGF水平的影响  

Effect of Laparoscopic Hepatectomy on Immunoglobulin and VEGF and AFGF Levels in Patients with Primary Liver Cancer

作　　者：陈加新[1] 胡嵩[1] 陈怡发 刘文涛 CHEN Jiaxin;HU Song;CHEN Yifa(Ezhou Central Hospital, Hubei Ezhou 436001, China)

机构地区：[1]湖北省鄂州市中心医院普外科,湖北鄂州436001 [2]湖北省襄阳市人民医院普外科,湖北襄阳436001

出　　处：《河北医学》2022年第4期604-608,共5页Hebei Medicine

基　　金：湖北省医学科技攻关计划项目,(编号:2018CFB783)。

摘　　要：目的:分析腹腔镜肝切除术对原发性肝癌患者免疫球蛋白及VEGF、aFGF水平的影响。方法:回顾性分析2019年9月至2020年9月于我院收治的80例原发性肝癌患者,根据手术方法分为观察组和对照组,观察组45例接受腹腔镜肝切除术,对照组35例接受传统开腹肝切除术,比较两组患者围手术期相关情况,手术后免疫功能指标、血管内皮生长因子(VEGF)和酸性成纤维细胞生长因子(aFGF)水平以及肝功能指标。结果:观察组手术时间与对照组相比,差异无统计学意义(P>0.05),观察组术中失血量明显少于对照组(P<0.05),观察组肛门首次排气时间和总住院时间与对照组相比更短(P<0.05);手术后观察组免疫球蛋白M(IgM)、免疫球蛋白A(IgA)和免疫球蛋白G(IgG)水平与对照组相比明显更高(P<0.05);手术后观察组VEGF和aFGF水平与对照组相比明显更低(P<0.05);手术后观察组总胆红素(TBil)、谷丙转氨酶(ALT)和谷草转氨酶(AST)含量与对照组相比明显更低(P<0.05)结论:与接受传统开腹肝切除术患者相比,采用腹腔镜肝切除术可改善围手术期相关情况,减轻对免疫功能的抑制,且能降低患者体内VEGF、aFGF水平和手术对肝脏功能造成的损伤。Objective:To analyze the effects of laparoscopic hepatectomy on the levels of immunoglobulin,VEGF and aFGF in patients with primary liver cancer.Methods:A retrospective analysis was performed on 80 patients with primary liver cancer admitted to our hospital from September 2019 to September 2020,who were divided into observation group and control group according to surgical methods.In the observation group,45 patients underwent laparoscopic hepatectomy and 35 patients in the control group underwent traditional open hepatectomy.The two groups were compared in terms of perioperative conditions,immune function indexes,vascular endothelial growth factor(VEGF)and acidic fibroblast growth factor(aFGF)levels and liver function indexes after surgery.Results:There was no statistically significant difference in the duration of surgery in the observation group compared with the control group(P>0.05);intraoperative blood loss was significantly less in the observation group compared with the control group(P<0.05);the time to first anal discharge and the total hospital stay were shorter in the observation group compared with the control group(P<0.05);immunoglobulin M(IgM),immunoglobulin A(IgA)and immunoglobulin G(IgG)levels were significantly higher in the observation group compared to the control group(P<0.05);VEGF and aFGF levels were significantly lower in the observation group compared to the control group(P<0.05);total bilirubin(TBil),alanine transaminase(ALT)and glutathione transaminase(AST)levels were significantly lower in the observation group compared to the control group after surgery(P<0.05).Conclusion:Compared with patients receiving traditional open hepatectomy,laparoscopic hepatectomy can improve perioperative conditions and reduce the inhibition of immune function.In addition,it can reduce the levels of VEGF and aFGF in patients and the injury of liver function caused by surgery.

关 键 词：原发性肝癌 腹腔镜肝切除术 免疫球蛋白 血管内皮生长因子 

分 类 号：R73[医药卫生—肿瘤]