腹腔镜下精准肝蒂解剖技术治疗原发性肝癌的效果及对患者肝功能、免疫功能的影响  

The Effect of Laparoscopic Precise Liver Pedicle Dissection Technique on the Treatment of Primary Liver Cancer and Its Impact on Liver Function and Immune Function in Patients

作　　者：陈栋兴 林梁 陈海 CHEN Dongxing;LIN Liang;CHEN Hai(Department of Hepatobiliary Pancreatic Spleen Surgery,Putian First Hospital,Putian 351199,China)

机构地区：[1]莆田市第一医院肝胆胰脾外科,福建莆田351199

出　　处：《临床医学工程》2025年第2期180-182,共3页Clinical Medicine & Engineering

摘　　要：目的探讨腹腔镜下精准肝蒂解剖技术在原发性肝癌(PLC)患者中的应用价值。方法选取2021年8月至2023年8月该院收治的92例PLC患者,以随机数字表法分为两组,各46例。两组均接受腹腔镜肝切除术(LH),对照组采用常规方式进行肝脏切除,观察组采用精准肝蒂解剖技术进行肝脏切除。比较两组术前及术后1 d、7 d的肝功能指标,免疫功能指标,同时对比术后随访1年两组患者的总体生存率(OS)、无复发生存率(RFS)。结果术后1 d,两组TBIL、γ-GT、AST、ALT水平均升高,术后7 d各项指标降低,且观察组相比对照组更低(P<0.05);术后1 d,两组IgA、IgM、IgG均降低,术后7 d各项指标升高,且观察组相比对照组更高(P<0.05)。两组OS比较,无统计学差异(P>0.05);观察组RFS高于对照组(P<0.05)。结论腹腔镜下精准肝蒂解剖技术应用于PLC患者,相比常规肝脏切除方式,在术后肝功能恢复、免疫功能保护以及提高无复发生存期方面具有一定优势。Objective To explore the application value of laparoscopic precise liver pedicle dissection technique in patients with primary liver cancer(PLC).Methods 92 patients with PLC admitted to the hospital from August 2021 to August 2023 were selected and randomly divided into two groups using a random number table method,with 46 patients in each group.Both groups underwent laparoscopic hepatectomy(LH),with the control group receiving routine liver resection and the observation group receiving precise liver pedicle dissection for liver resection.The liver function indicators,immune function indicators before surgery and 1 d,7 d after surgery and the overall survival rate(OS)and recurrence free survival rate(RFS)of patients followed up for one year after surgery were compared between the two groups.Results One day after operation,the levels of TBIL,γ-GT,AST,and ALT increased in both groups,and decreased on 7 d postoperatively,and the levels of the observation group were lower than those of the control group(P<0.05);One day after operation,the levels of IgA,IgM,and IgG decreased in both groups,and increased on 7 d postoperatively,the levels of the observation group were higher than those of the control group(P<0.05);No statistically significant difference showed in OS between the two groups(P>0.05);The RFS of the observation group was higher than that of the control group(P<0.05).Conclusions The application of laparoscopic precise liver pedicle dissection technique in PLC patients has certain advantages over conventional liver resection methods in postoperative liver function recovery,immune function protection,and improving recurrence free survival.

关 键 词：原发性肝癌 腹腔镜肝切除术 精准肝蒂解剖 肝功能 免疫功能 

分 类 号：R735.7[医药卫生—肿瘤]