摘要
目的探讨腹腔镜下精准肝切除术对原发性肝癌(PLC)患者肝功能及血管内皮生长因子(VEGF)、甲胎蛋白(AFP)表达水平的影响。方法选取2018年6月至2019年6月本院收治的160例PLC患者作为研究对象,随机将其分为对照组和试验组,各80例。对照组采用传统开腹肝癌切除术治疗,试验组采用腹腔镜下精准肝切除术治疗。比较两组患者手术指标及术后恢复指标,治疗前、后的肝功能指标、AFP、同型半胱氨酸(HCY)、VEGF水平,并对所有患者进行为期1年的随访,比较两组的肿瘤复发率及生存率。结果试验组手术时间显著长于对照组,术后排气时间和住院时间显著短于对照组,术中出血量与输血量显著少于对照组(P<0.05)。治疗后,两组患者血清中STB、AST、ALT水平均较治疗前显著升高,但试验组显著低于对照组(P<0.05)。治疗后,两组患者血清中AFP、HCY、VEGF水平均较治疗前显著降低,且试验组低于对照组(P<0.05)。随访1年期间,试验组肿瘤复发率为23.75%,显著低于对照组的42.50%(P<0.05);试验组生存率为85.00%,与对照组的76.25%无显著差异(P>0.05)。结论行腹腔镜下精准肝切除术的PLC患者术后康复更快,肝功能状态更好,且近期预后更为满意。
Objective To investigate the effects of precise laparoscopic hepatectomy on liver function and the expression levels of vascular endothelial growth factor(VEGF) and alpha fetal protein(AFP) in patients with primary liver cancer(PLC).Methods A total of 160 patients with PLC treated in our hospital from June 2018 to June 2019 were selected as the study objects and randomly divided into control group and experimental group,with 80 cases in each group.The control group was treated with traditional open hepatocellular carcinoma resection,while the experimental group was treated with precise laparoscopic hepatectomy.The surgical indexes and postoperative recovery indexes,liver function indexes,AFP,homocysteine(HCY) and VEGF levels before and after treatment were compared between the two groups.All patients were followed up for 1 year,the tumor recurrence rate and survival rate were compared between the two groups.Results The operation time of the experimental group was significantly longer than that of the control group,the postoperative exhaust time and hospitalization time were significantly shorter than those of the control group,and the intraoperative blood loss volume and blood transfusion volume were significantly less than those of the control group(P<0.05).After treatment,the levels of serum STB,AST and ALT in the two groups were significantly higher than those before treatment,but those in the experimental group were significantly lower than the control group(P<0.05).After treatment,the levels of serum AFP,HCY and VEGF in the two groups were significantly lower than those before treatment,and those in the experimental group were lower than the control group(P<0.05).During 1 year follow-up,the tumor recurrence rate of the experimental group was23.75%,which was significantly lower than 42.50% of the control group(P<0.05);the survival rate of the experimental group was 85.00%,which had no significant difference from 76.25% of the control group(P >0.05).Conclusion PLC patients undergoing precise laparoscopic hepatectomy have faster postoperative recovery,better liver function and more satisfactory short-term prognosis.
作者
张秋月
ZHANG Qiuyue(General Surgery Department,Nanyang First People's Hospital,Nanyang 473000,China)
出处
《临床医学研究与实践》
2022年第1期39-41,109,共4页
Clinical Research and Practice
关键词
精准肝切除术
原发性肝癌
肝功能
血管内皮生长因子
甲胎蛋白
precise hepatectomy
primary liver cancer
liver function
vascular endothelial growth factor
alpha fetal protein
