腹腔镜下不同肝血流阻断术治疗肝癌的效果及对患者肠道菌群的影响  

Effect of Different Laparoscopic Liver Blood Flow Occlusion in the Treatment of Liver Cancer and the Impact on the Intestinal Microbiota of Patients

作　　者：杨超 张空 刘竞航 YANG Chao;ZHANG Kong;LIU Jinghang(Surgery Department of Hepatobiliary Disease Diagnosis and Treatment Center,Nanyang First People's Hospital,Nanyan 473000,China)

机构地区：[1]南阳市第一人民医院肝胆病诊疗中心外科,河南南阳473000

出　　处：《临床医学工程》2024年第7期789-790,共2页Clinical Medicine & Engineering

摘　　要：目的探讨腹腔镜下不同肝血流阻断术治疗肝癌的效果及对患者肠道菌群的影响。方法选取123例于我院行腹腔镜右半肝解剖性切除的肝癌患者,根据术中肝血流阻断方式分为研究组(右肝蒂Glisson鞘外血流阻断)与对照组(Pringle血流阻断)。比较两组围术期指标、炎性指标及肝功能指标、肠道菌群及预后情况。结果研究组手术时间、住院时间短于对照组,并发症发生率低于对照组(P<0.05)。术后,研究组IL-6、hs-CRP、ALT及AST水平低于对照组(P<0.05)。术后,研究组肠道益生菌水平高于对照组,而肠道致病菌水平低于对照组(P<0.05)。1年后,两组患者的生存率比较差异无统计学意义(P>0.05)。结论腹腔镜下右半肝切除中行右肝蒂Glisson鞘外血流阻断对肝癌患者的效果更佳,可减轻炎性反应及肝功能受损程度,促进患者康复,值得临床推广应用。Objective To explore the effect of laparoscopic liver blood flow occlusion in the treatment of liver cancer and the impact on the intestinal microbiota of patients.Methods 123 patients with liver cancer undergoing laparoscopic right hemihepatectomy in our hospital were selected and divided into study group(Glisson extrathecal blood flow occlusion of right hepatic pedicle)and control group(Pringle blood flow occlusion)according to different liver blood flow occlusion during surgery.The perioperative indicators,inflammatory indicators,liver function indicators,intestinal microbiota,and prognosis were compared between the two groups.Results The surgical time and hospitalization time of the study group were shorter than those of the control group,and the incidence of complications was lower than that of the control group(P<0.05).After surgery,the IL-6,hs-CRP,ALT and AST levels of the study group were lower than those of the control group(P<0.05).After surgery,the intestinal probiotics of the study group were higher than those of the control group,while the intestinal pathogens were lower than those of the control group(P<0.05).After 1 year,no statistical difference was found in the survival rate between the two groups(P>0.05).Conclusions Glisson extrathecal blood flow occlusion of right hepatic pedicle during laparoscopic right hemihepatectomy has better effect on patients with liver cancer,which can reduce the inflammatory reactions and liver function damage,promote patients'recovery,and is worthy of clinical promotion and application.

关 键 词：腹腔镜 原发性肝癌 Glisson阻断 Pringle阻断 右半肝切除术 

分 类 号：R735.7[医药卫生—肿瘤]