腹腔镜解剖性肝切除术治疗原发性肝癌的临床研究  

Clinical study on laparoscopic anatomical hepatectomy for primary liver cancer

作　　者：买二辉[1] 查中明 丁飞虎 齐梦剑 徐涛[1] Mai Erhui;Zha Zhongming;Ding Feihu;Qi Mengjian;Xu Tao(Department of Hepatobiliary Pancreatic Spleen Hernia,the Central Hospital of Luoyang,Luoyang 471000,China)

机构地区：[1]河南省洛阳市中心医院肝胆胰脾疝外科,471000

出　　处：《临床医学》2025年第3期8-11,共4页Clinical Medicine

摘　　要：目的 探讨腹腔镜解剖性肝切除术治疗原发性肝癌的临床效果。方法 选择2019年3月至2024年1月洛阳市中心医院收治的60例原发性肝癌患者为研究对象,按照手术方式分为对照组与研究组,每组30例。对照组实施腹腔镜非解剖性肝切除术治疗,研究组实施腹腔镜解剖性肝切除术治疗。比较两组手术指标(手术时间、术中出血量、术中输血量、术后住院时间)、肝功能指标[总胆红素(TBIL)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)]水平、炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)]水平、并发症及随访6个月预后。结果 两组手术时间比较,差异未见统计学意义(P>0.05),研究组术中出血量、术中输血量、术后住院时间均低于对照组,差异有统计学意义(P<0.05)。术后7 d,两组TBIL、AST、ALT均高于术前,但研究组升高差值均低于对照组,差异有统计学意义(P<0.05)。重复测量显示,TNF-α、IL-8、IL-10时点效应、组间效应、交互效应比较,差异有统计学意义(P<0.05);术后3 d、术后7 d,两组TNF-α、IL-8、IL-10水平均高于术前,但研究组均低于对照组,差异有统计学意义(P<0.05)。研究组并发症发生率低于对照组,无瘤生存率高于对照组,复发率低于对照组,差异有统计学意义(P<0.05)。KM生存分析显示,研究组无瘤生存期优于对照组,差异有统计学意义(P<0.05)。结论 腹腔镜解剖性肝切除术治疗原发性肝癌可有效改善肝功能损伤,减轻炎症反应,降低并发症发生率,提高无瘤生存率。Objective To investigate the clinical efficacy of laparoscopic anatomical liverresection on primary liver cancer.Methods Sixty patients with primary liver cancer treated in theCentral Hospital of Luoyang from March 2019 to January 2024 were selected as the study objects,anddivided into study group and control group according to different surgical treatment methods,with 30cases in each group.The control group underwent laparoscopic nonanatomic hepatectomy,and the studygroup underwent laparoscopic anatomic hepatectomy.The surgical indexes(operation time,intraoperativeblood loss,intraoperative blood transfusion,postoperative hospital stay),liver function indexes[totalbilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT')],inflammatoryfactors[tumor necrosis factor-α(TNF-a),interleukin-8(IL-8),interleukin-10(IL-10)]levels,complications,and 6-month follow-up prognosis between the two groups were compared.ResultsTherewas no significant difference in operation time between the two groups(P>0.05),but the amount ofintraoperative blood loss,intraoperative blood transfusion and postoperative hospital stay in the studygroup were lower than those in the control group(P<0.05).Compared with before surgery,the levelsof TBIL,AST and ALT were increased in both groups 7 days after surgery(P<0.05),but the differenceof increase in the study group was lower than that in the control group(P<0.05).Repeatedmeasurements showed that the time-point effect,intergroup effect and interaction effect of TNF-a,IL.-8and IL-10 were significant(P<0.05),and the levels of'TNF-a,IL-8 and IL-10 in both groups wereincreased 3 and 7 days after surgery compared with those before surgery(P<0.05).However,those ofthe study group was lower than those of the control group(P<0.05).Compared with the control group,the total complication rate of the study group was lower(P<0.05).The tumor free survival rate of thestudy group was higher than that of the control group,and the recurrence rate was lower than that of thecontrol group(P<0.05).KM s

关 键 词：原发性肝癌 腹腔镜 解剖性肝切除术 临床效果 

分 类 号：R735.7[医药卫生—肿瘤]