载药微球经动脉导管化疗栓塞与腹腔镜精准肝切除术治疗原发性肝癌的疗效比较  

Efficacy comparison of drug loaded microspheres in transcatheter arterial chemoembolization and laparoscopic precise hepatectomy for primary liver cancer

作　　者：房芳[1] 李俊娜 王前 FANG Fang;LI Jun-na;WANG Qian(General Surgery,Nanyang Central Hospital,Nanyang Henan,473005,China)

机构地区：[1]南阳市中心医院普通外科肝脏病区,河南南阳473005

出　　处：《中西医结合肝病杂志》2024年第7期596-599,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：河南省社发领域科技攻关项目(No.192102310326)。

摘　　要：目的:比较载药微球经动脉导管化疗栓塞与腹腔镜精准肝切除术治疗原发性肝癌的疗效。方法:选取2021年3月至2022年11月105例原发性肝癌患者为研究对象,按照随机数字表法分为研究组55例和对照组50例。对照组患者采用腹腔镜精准肝切除术,研究组患者采用载药微球经动脉导管化疗栓塞。观察两组患者肝功能、T淋巴细胞亚群、应激指标、生存质量、术后6个月内并发症发生情况及临床疗效。结果:术后3 d,两组患者AST、ALT、TBil、E、NE、IL-6较治疗前升高,但研究组低于对照组(P<0.05)。术后3 d,两组患者CD3^(+)、CD4^(+)较治疗前降低,但研究组高于对照组;CD8^(+)较治疗前升高,但研究组低于对照组(P<0.05)。术后3 d,两组患者社会功能、角色功能、躯体功能、认知功能、情绪功能评分较治疗前升高,且研究组高于对照组(P<0.05)。与对照组相比,研究组患者术后6个月内腹腔积液、出血、肺部感染、胆瘘总发生率较低(P<0.05)。结论:对原发性肝癌患者采取载药微球经动脉导管化疗栓塞与腹腔镜精准肝切除术进行治疗均取得较好临床效果,但载药微球经动脉导管化疗栓塞对肝功能调节效果更为明显,并发症发生率较低,安全度相对较高,临床效果较好。Objective:Compare the efficacy of drug-loaded microsphere transarterial catheter chemoembolization and laparoscopic precision liver resection for the treatment of primary liver cancer.Methods:A total of 105 primary liver cancer patients treated from March 2021 to November 2022 were selected as the study subjects,which were divided into 55 study groups and 50 control groups according to the random number table method.The control group used laparoscopic precision hepatectomy,and the study group used drug-loaded microsphere transarterial catheter chemoembolization.The liver function,T lymphocyte subsets,quality of survival,stress indicators,and occurrence of complications within six months were surgery.Results:On the third day after surgery,the AST,ALT,TBiL,E,NE,and IL-6 increased in both groups,but the study group was lower than that in the control group(P<0.05).On the third day after surgery,CD3^(+)and CD4^(+)decreased in both groups,but the study group was higher than the control group,and CD8^(+)increased,but the study group was lower than the control group(P<0.05).On the third day after surgery,the scores of social function,role function,physical function,cognitive function,and emotional function were increased in the two groups,and the study group was higher than the control group(P<0.05).Compared with the control group,the overall incidence of abdominal effusion,hemorrhage,pulmonary infection,and biliary fistula was lower in the study group(P<0.05).Conclusion:Drug-loaded microsphere transarterial catheter chemoembolization and laparoscopic precision hepatocatectomy achieved good results,but drug-loaded microsphere transarterial catheter chemoembolization had a more obvious effect on liver function regulation,with low complication rate,relatively high safety degree,and good clinical effect.

关 键 词：原发性肝癌 载药微球经动脉导管化疗栓塞 腹腔镜精准肝切除术 临床疗效 

分 类 号：R735.7[医药卫生—肿瘤]