解剖性肝叶切除术对原发性肝癌患者肝功能指标的影响  

Effect of anatomical liver lobectomy on liver function indicators in patients with primary liver cancer

作　　者：万云杰[1] 张志忠[1] 刘志强[1] 李保中[1] WAN Yunjie;ZHANG Zhizhong;LIU Zhiqiang;LI Baozhong(Department of Abdominal Tumor Surgery,Anyang Tumor Hospital,Anyang 455000,He’nan,China)

机构地区：[1]安阳市肿瘤医院腹部肿瘤外科,河南安阳4550000

出　　处：《癌症进展》2023年第11期1242-1245,共4页Oncology Progress

摘　　要：目的探讨解剖性肝叶切除术对原发性肝癌患者肝功能指标的影响。方法根据手术方法的不同将106例原发性肝癌患者分为对照组(n=53)和观察组(n=53),对照组患者给予非解剖性肝叶切除术,观察组患者给予解剖性肝叶切除术。比较两组患者的手术相关指标、肝功能指标[丙氨酸转氨酶(ALT)、直接胆红素(DBIL)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)]、术后并发症发生情况、黑色素瘤相关抗原1(MAGE1)mRNA和甲胎蛋白(AFP)m RNA的阳性表达率。结果观察组患者手术时间、住院时间均明显短于对照组,术中出血量、术中输血量均明显少于对照组,差异均有统计学意义(P<0.01)。术后7天,两组患者血清ALT、AST、TBIL、DBIL水平均高于本组术前,观察组患者ALT、AST、TBIL、DBIL水平均低于对照组,差异均有统计学意义(P<0.05)。术后4周,两组患者MAGE1、AFP m RNA阳性表达率均低于本组术前,观察组患者MAGE1、AFP mRNA阳性表达率均低于对照组,差异均有统计学意义(P<0.05)。观察组患者的并发症总发生率为26.42%,低于对照组患者的45.28%,差异有统计学意义(P<0.05)。结论解剖性肝叶切除术治疗原发性肝癌,可有效改善患者的手术相关指标及肝功能指标,有利于降低并发症总发生率,安全性较高。Objective To analyze the effect of anatomical liver lobectomy on liver function indicators in patients with primary liver cancer.Method A total of 106 patients with primary liver cancer were divided into control group(n=53)and observation group(n=53)based on different surgical methods.The control group received non-anatomical liver lobec-tomy,while the observation group received anatomical liver lobectomy.The operation related indexes,liver function in-dexes[alanine aminotransferase(ALT),direct bilirubin(DBIL),aspartate aminotransferase(AST),total bilirubin(TBIL)],postoperative complications,and the positive expression rates of melanoma-associated antigen 1(MAGE1)mRNA andα-fetal protein(AFP)mRNA were compared between the two groups.Result The observation group had sig-nificantly shorter surgical and hospitalization time compared to the control group,with significantly less intraoperative bleeding and blood transfusion compared to the control group,and the differences were statistically significant(P<0.01).On the 7th day after surgery,the serum levels of ALT,AST,TBIL,and DBIL in both groups were higher than those be-fore surgery,the levels of ALT,AST,TBIL,and DBIL in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).At 4 weeks after surgery,the positive expression rates of MAGE1 mRNA and AFP mRNA in both groups were lower than those before surgery,the positive expression rates of MAGE1 mRNA and AFP mRNA in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was 26.42%,lower than 45.28%in the control group,the difference was statistically significant(P<0.05).Conclusion Anatomical liver lo-bectomy for the treatment of primary liver cancer can effectively improve the surgical and liver function indicators of pa-tients,reduce the overall incidence of complications,and have high safety.

关 键 词：原发性肝癌 解剖性肝叶切除术 非解剖性肝叶切除术 术后并发症 

分 类 号：R735.7[医药卫生—肿瘤]