三维重建技术结合腹腔镜精准肝切除术对肝癌患者术后CD4+、CD8+及免疫球蛋白水平的影响  

Effects of 3D reconstruction technology combined with laparoscopic precision hepatectomy on the levels of CD4+,CD8+and immunoglobulin in patients with liver cancer after surgery

作　　者：赖全友 高远 汪建林 屈士斌 魏丹 彭伟 Lai Quanyou;Gao Yuan;Wang Jianlin;Qu Shibin;Wei Dan;Peng Wei(Department of Hepatobiliary Surgery,Xijing Hospital,Air Force Medical University,Xi'an Shaanxi Province 710032,China)

机构地区：[1]空军军医大学第一附属医院肝胆胰脾外科,西安710032

出　　处：《中华普外科手术学杂志（电子版）》2024年第6期651-654,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然科学基金青年项目(82203443)。

摘　　要：目的探讨三维重建技术结合腹腔镜精准肝切除术对肝癌患者术后CD4+、CD8+及免疫球蛋白水平的影响。方法回顾性分析2021年4月至2023年3月384例肝癌患者临床资料,按照手术方式分为两组,每组患者各192例,对照组采用腹腔镜精准肝切除术治疗,观察组采用三维重建技术结合腹腔镜精准肝切除术。采用软件SPSS 26.0分析数据,临床疗效、不良反应发生率等计数资料采用[例(%)]表示,行χ^(2)检验;CD4+、CD8+和免疫球蛋白水平等计量资料采用(χ±s)表示,行独立样本t检验。P<0.05为差异有统计学意义。结果相较于对照组患者,观察组患者手术时间、术后首次下床活动时间均更短(P<0.05)、术中出血量更少(P<0.05);手术后两组患者血清甲胎蛋白(AFP)水平均下降(P<0.05),且观察组低于对照组(P<0.05);手术后两组患者CD4+、IgM、IgG水平均下降(P<0.05),CD8+、IgA水平与手术前相比差异均不显著(P>0.05);且观察组患者CD4+、CD8+和免疫球蛋白水平与对照组比较差异均不显著(P>0.05);观察组患者并发症总发生率低于对照组(P<0.05);观察组患者术后1年肿瘤复发率和死亡率与对照组比较差异均不显著(P>0.05)。结论三维重建技术结合腹腔镜精准肝切除术并未减轻对肝癌患者术后CD4+、CD8+及免疫球蛋白水平的影响,但可以减少并发症发生。Objective To investigate the effects of 3D reconstruction technology combined with laparoscopic precision hepatectomy on the levels of CD4+,CD8+and immunoglobulin in patients with liver cancer after surgery.Methods The clinical data of 384 patients with liver cancer from April 2021 to March 2023 were retrospectively analyzed and divided into two groups according to surgical methods,192 patients in each group.The control group was treated with laparoscopic precision hepatectomy,and the observation group was treated with three-dimensional reconstruction technology combined with laparoscopic precision hepatectomy.SPSS 26.0 software was used to analyze the data.Clinical efficacy,incidence of adverse reactions and other statistical data were expressed by[cases(%)]andχ^(2) test was performed.Measurement data such as CD4+,CD8+and immunoglobulin levels were expressed by(χ±s),and independent sample t test was performed.P<0.05 was considered statistically significant.Results Compared with the control group,the operation time and the first time of getting out of bed after operation in the observation group were shorter(P<0.05),and the amount of blood loss during operation was less(P<0.05).After operation,the serum alpha-fetoprotein(AFP)level of both groups was decreased(P<0.05),and the observation group was lower than the control group(P<0.05).After surgery,the levels of CD4+,IgM and IgG were all decreased(P<0.05),while the levels of CD8+and IgA were not significantly different compared with those before surgery(P>0.05).The levels of CD4+,CD8+and immunoglobulin in observation group were not significantly different from those in control group(P>0.05).The total complication rate of observation group was lower than that of control group(P<0.05).There were no significant differences in the recurrence rate and mortality of tumor in observation group and control group at 1 year after surgery(P>0.05).Conclusion 3D reconstruction combined with laparoscopic precision hepatectomy did not reduce the effects on the levels of CD4+,CD

关 键 词：肝肿瘤 腹腔镜 肝切除术 成像 三维 CD4阳性T淋巴细胞 CD8阳性T淋巴细胞 免疫球蛋白G 

分 类 号：R735.7[医药卫生—肿瘤]