首页|腹腔镜规则性肝叶切除术对原发性肝癌患者肝功能、免疫功能、血清AFP、Hcy水平的影响

腹腔镜规则性肝叶切除术对原发性肝癌患者肝功能、免疫功能、血清AFP、Hcy水平的影响

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目的:探究腹腔镜规则性肝叶切除术对原发性肝癌(PLC)患者肝功能、免疫功能、血清甲胎蛋白(AFP)、同型半胱氨酸(Hcy)水平的影响.方法:回顾性分析 2019 年 1 月—2023 年 6 月于贵州省人民医院接受手术治疗的 200 例PLC患者的临床资料,将行开腹手术的 100 例患者纳入对照组,行腹腔镜规则性肝叶切除术的 100 例患者纳入观察组.观察两组术后肝功能[总胆红素(TBIL)、白蛋白(ALB)、丙氨酸转移酶(ALT)、天冬氨酸氨基转移酶(AST)]、免疫功能(CD8+、CD4+、CD3+)、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]及血清AFP、Hcy水平的变化情况.结果:术前,两组肝功能、免疫功能、炎症因子、血清AFP、Hcy水平比较,差异无统计学意义(P>0.05);术后 1 d,两组ALB高于术前,TBIL、ALT、AST及术后 5 d的AFP、Hcy均低于术前,且研究组ALB高于对照组,TBIL、ALT、AST、AFP、Hcy低于对照组,差异有统计学意义(P<0.05);术后 5 d,对照组TNF-α、IL-6 水平均高于术前,CD8+、CD4+、CD3+水平均低于术前,差异有统计学意义(P<0.05),术后 5 d,研究组TNF-α、IL-6 水平均低于对照组,CD8+、CD4+、CD3+水平均高于对照组,差异有统计学意义(P<0.05).结论:PLC患者予以腹腔镜规则性肝叶切除术治疗可明显降低患者术后血清AFP、Hcy水平,降低炎症因子水平,提高免疫力,恢复肝功能.
Effects of Laparoscopic Regular Hepatic Lobectomy on Liver Function,Immune Function,Serum AFP and Hcy Levels in Patients with Primary Liver Cancer
Objective:To explore the effects of laparoscopic regular hepatic lobectomy on liver function,immune function,serum alpha-fetoprotein(AFP)and homocysteine acid(Hcy)levels in patients with primary liver cancer(PLC).Method:The clinical data of 200 patients with PLC who received surgical treatment in Guizhou Provincial People's Hospital from January 2019 to June 2023 were retrospectively analyzed.A total of 100 patients who underwent open surgery were selected as the control group,and 100 patients who underwent laparoscopic regular hepatic lobectomy were selected as the observation group.Changes in liver function[total bilirubin(TBIL),albumin(ALB),alanine transferase(ALT),aspartate aminotransferase(AST)],immune function(CD8+,CD4+,CD3+),inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]and serum AFP,Hcy levels were observed in the two groups after operation.Result:Before operation,there were no significant differences in liver function,immune function,inflammatory factors,serum AFP and Hcy levels between the two groups(P>0.05).After 1 d of surgery,ALB was higher than that before surgery in both groups,TBIL,ALT,AST,AFP and Hcy at 5 d after surgery were lower than those before surgery,and ALB in the study group was higher than that in the control group,TBIL,ALT,AST,AFP and Hcy were lower than those in the control group,the differences were statistically significant(P<0.05).After 5 d of surgery,the levels of TNF-α and IL-6 in the control group were higher than those before surgery,and the levels of CD8+,CD4+and CD3+were lower than those before surgery,the differences were statistically significant(P<0.05).After 5 d of surgery,the levels of TNF-α and IL-6 in the study group were lower than those in the control group,and the levels of CD8+,CD4+and CD3+were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Laparoscopic regular hepatic lobectomy can significantly reduce serum AFP and Hcy levels,reduce inflammatory factors,improve immunity and restore liver function in patients with primary liver cancer.

Primary liver cancerLaparoscopic regular hepatic lobectomyOpen hepatectomyLiver functionImmune functionSerum alpha-fetoproteinHomocysteine

黎涛、石承先

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贵州省人民医院 贵州 贵阳 550499

原发性肝癌 腹腔镜规则性肝叶切除术 开腹手术 肝功能 免疫功能 血清甲胎蛋白 同型半胱氨酸

2024

中外医学研究
中国医院管理杂志社

中外医学研究

影响因子:1.149
ISSN:1674-6805
年,卷(期):2024.22(22)
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