摘要
目的探讨腹腔镜下肝癌切除术对患者免疫功能和肝功能的影响。方法根据手术方法不同将80例肝癌患者分为微创组(行腹腔镜下肝癌切除术)和开腹组(行传统开腹手术),每组40例。观察并比较两组患者的手术时间、术中出血量、切口长度、引流管留置时间、住院时间,并对两组患者术前、术后1天、术后3天的丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)、间接胆红素(DBIL)水平及外周血CD3~+、CD4~+、CD8~+水平进行比较。结果微创组患者的手术时间明显长于开腹组,切口长度、引流管留置时间、住院时间均明显短于开腹组,术中出血量明显低于开腹组(P﹤0.01);术后1天、术后3天,微创组患者的血清ALT、AST水平及外周血CD8~+水平均低于开腹组,外周血CD3~+、CD4~+、CD4~+/CD8~+水平均高于开腹组,差异均有统计学意义(P﹤0.05)。结论腹腔镜下肝癌切除术对患者免疫功能、肝功能的影响较传统开腹手术小。
Objective To investigate the effects of laparoscopic hepatectomy for liver cancer on immune function and liver function of patients. Method 80 patients with liver cancer were divided into minimally invasive group(laparoscopic hepatectomy was performed) and laparotomy group(traditional laparotomy was performed) according to the surgical methods, with 40 cases in each group. The operation duration, intraoperative blood loss, incision length, drainage tube indwelling time, and hospitalization duration of the two groups were observed and compared. Alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin(TBIL), indirect bilirubin(DBIL) and peripheral blood CD3~+,CD4~+, and CD8~+ levels before operation, 1 day and 3 days after operation were compared in the two groups. Result The operation duration of the patients in the minimally invasive group was significantly longer than that in the laparotomy group. The incision length, drainage tube indwelling time, hospitalization duration and intraoperative blood loss were significantly lower than those in the laparotomy group(P<0.01). At 1 day and 3 days after operation, serum ALT, AST levels and peripheral blood CD8~+ levels in the minimally invasive group were significantly lower than those in the laparotomy group, and the peripheral blood CD3~+, CD4~+, CD4~+/CD8~+ levels were higher than those in the laparotomy group, all with statistical significance(P<0.05). Conclusion There are less effects of laparoscopic hepatectomy for liver cancer on immune function and liver function of patients compared with traditional laparotomy surgery.
引文
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