摘要
目的:比较腹腔镜与开腹肝切除术治疗原发性大肝癌患者的疗效。方法:选取80例原发性大肝癌患者为研究对象,按随机数字表法分为对照组和观察组各40例,对照组实施开腹肝切除术,观察组实施腹腔镜肝切除术,比较两组手术相关指标水平、并发症发生率、免疫功能指标水平及远近期生存率。结果:观察组手术时间长于对照组,差异有统计学意义(P<0.05);观察组术中出血量明显少于对照组,术后下床活动时间、术后肛门排气时间及术后住院时间均明显短于对照组,差异均有统计学意义(P<0.05);观察组并发症发生率为7.50%,明显低于对照组的25.00%,差异有统计学意义(P<0.05);术后两组CD4+、免疫球蛋白G及免疫球蛋白M水平均低于术前,且观察组均高于对照组,差异有统计学意义(P<0.05);术后两组CD8+水平均高于术前,且观察组低于对照组,差异有统计学意义(P<0.05);两组术后1年和术后3年生存率比较,差异均无统计学意义(P>0.05)。结论:腹腔镜肝切除术治疗原发性大肝癌的远期疗效与开腹肝切除术相当,但腹腔镜肝切除术创伤更小,对免疫功能影响更小,且并发症更少,恢复更快。
Objective: To compare effects of laparoscopic and open hepatectomy on patients with primary hepatocellular carcinoma. Methods: 80 patients with primary hepatocellular carcinoma were selected as the research subjects, and were divided into the control group(n=40) and observation group(n=40) according to the random number table method. The control group underwent open hepatectomy, while the observation group was given laparoscopic hepatectomy. Then, the levels of surgical-related indicators, complications, immune function indicators, and long-term and short-term survival rates were compared between the two groups. Results: The operation time in the observation group was longer than that in the control group, and the difference was statistically significant(P<0.05). The intraoperative blood loss in the observation group was significantly less than that in the control group;the out-of-bed activity time, the postoperative anal exhaust time, and the hospital stay were significantly shorter than those in the control group;and the differences were statistically significant(P<0.05). The incidence of complications in the observation group was 7.50%, which was significantly lower than the 25.00% in the control group, and the difference was statistically significant(P<0.05). The levels of CD4+, immunoglobulin G, and immunoglobulin M in the two groups after the surgery were lower than those before the surgery;those of the observation group were higher than those of the control group;and the differences were statistically significant(P<0.05). The CD8+ levels in the two groups after the surgery were higher than those before the surgery;that of the observation group was lower than that of the control group;and the differences were statistically significant(P<0.05). However, there were no significant differences in the 1-year and 3-year survival rate between the two groups(P>0.05). Conclusions: Laparoscopic hepatectomy for the primary large hepatocellular carcinoma has the same long-term effects as open hepatectomy. However, laparoscopic hepatectomy has fewer traumas, less impact on the immune function, fewer complications and faster recovery.
作者
李照阳
LI Zhaoyang(Zhecheng People’s Hospital,Shangqiu 476200 Henan,China)
出处
《中国民康医学》
2020年第5期11-13,共3页
Medical Journal of Chinese People’s Health
关键词
原发性大肝癌
腹腔镜
肝切除
开腹
Primary large hepatocellular carcinoma
Laparoscopy
Hepatectomy
Open surgery
作者简介
李照阳(1987.12-),男,汉族,本科,主治医师,研究方向:临床外科。邮箱:zhaoyanj68jd@163.com。
