二种手术方法治疗原发性肝癌的疗效及趋化因子12水平比较
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摘要
目的研究完全腹腔镜根治术与开腹术治疗原发性肝癌的疗效及趋化因子12动态变化。方法回顾性分析2015年5月至2017年10月期间接受诊治的92例原发性肝癌患者临床资料,根据患者手术方式不同分成开腹组43例(开腹手术)、腹腔镜组49例(完全腹腔镜根治术)。采用SPSS20.0统计学软件,术后恢复情况、手术前后趋化因子12动态变化计量资料采用■±s表示,独立t检验;术后并发症发生率采用χ~2检验;以P<0.05为差异有统计学意义。结果腹腔镜组术后并发症发生率、术后引流管留置时间、术后首次进食时间、术后住院时间均低于开腹组(P<0.05);随着术后恢复时间增加,两组趋化因子12的表达水平逐渐降低(P<0.05),腹腔镜组术后1 d、3 d、7 d趋化因子12水平均低于开腹组(P<0.05);腹腔镜组术后7 d趋化因子12降至正常水平。结论完全腹腔镜根治术治疗原发性肝癌疗效确切,术后并发症发生率低,术后恢复快,能减轻机体炎症反应。
Objective To study the efficacy of total laparoscopic radical surgery and open surgery in treatment of primary liver cancer and its influence on dynamic changes of chemokine 12.Methods The clinical data of 92 patients with primary liver cancer in our hospital from May 2015 to October 2017 were retrospectively analyzed.All the patients were divided into 43 cases of open group(open surgery)and 49cases of laparoscopic group(total laparoscopic radical surgery)by surgical procedures.SPSS20.0 statistical software was adopted,the measurement data of postoperative recovery,dynamic changes of chemokine 12 before and after surgery were expressed by(■±s),and independent t test was adopted;The incidence of postoperative complications was measured byχ~2 test;P<0.05 was considered statistically significant.Results The incidence of postoperative complications,postoperative drainage tube indwelling time,postoperative first feeding time,postoperative hospital stays in laparoscopic group were lower than those in open group(P<0.05);The chemokine 12 expression levels in two groups gradually decreased as postoperative recovery time increased(P<0.05),and the postoperative 1 d,3 d,7 d chemokine 12 levels in laparoscopic group were lower than those in open group(P<0.05);There was no statistical difference in the postoperative 7 d chemokine 12 level between laparoscopic group and healthy group(P>0.05).Conclusion Total laparoscopic radical surgery in treatment of primary liver cancer is effective,it can achieve low incidence of postoperative complications and quicj postoperative recovery,and the chemokine 12 level quickly decreases.
Objective To study the efficacy of total laparoscopic radical surgery and open surgery in treatment of primary liver cancer and its influence on dynamic changes of chemokine 12.Methods The clinical data of 92 patients with primary liver cancer in our hospital from May 2015 to October 2017 were retrospectively analyzed.All the patients were divided into 43 cases of open group(open surgery)and 49cases of laparoscopic group(total laparoscopic radical surgery)by surgical procedures.SPSS20.0 statistical software was adopted,the measurement data of postoperative recovery,dynamic changes of chemokine 12 before and after surgery were expressed by(■±s),and independent t test was adopted;The incidence of postoperative complications was measured byχ~2 test;P<0.05 was considered statistically significant.Results The incidence of postoperative complications,postoperative drainage tube indwelling time,postoperative first feeding time,postoperative hospital stays in laparoscopic group were lower than those in open group(P<0.05);The chemokine 12 expression levels in two groups gradually decreased as postoperative recovery time increased(P<0.05),and the postoperative 1 d,3 d,7 d chemokine 12 levels in laparoscopic group were lower than those in open group(P<0.05);There was no statistical difference in the postoperative 7 d chemokine 12 level between laparoscopic group and healthy group(P>0.05).Conclusion Total laparoscopic radical surgery in treatment of primary liver cancer is effective,it can achieve low incidence of postoperative complications and quicj postoperative recovery,and the chemokine 12 level quickly decreases.
引文
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[3] 刘志发,王继才,苏志雷,等.腹腔镜肝切除术与开腹肝切除术治疗肝癌的短期临床疗效比较[J].医学综述,2018,24(9):1847-1851.
[4] 李敬东,李强.腹腔镜肝切除术在肝癌手术中的应用[J].肿瘤预防与治疗,2017,30(4):243-246,260.
[5] 丁振昊,蒋力,张珂,等.腹腔镜与开放式肝癌切除术治疗原发性肝癌患者临床效果对比分析[J].临床和实验医学杂志,2015,14(13):1113-1116.
[6] Wang XT,Wang HG,Duan WD,et al.Pure Laparoscopic Versus Open Liver Resection for Primary Liver Carcinoma in Elderly Patients:A Single-Center,Case-Matched Study[J].Medicine,2015,94(43):e1854.
[7] 柴松山,王健,项帅,等.单中心腹腔镜下肝癌肝切除术457例分析[J/CD].中华普外科手术学杂志(电子版),2017,11(5):376-379.
[8] 罗庆丰.趋化因子12与肿瘤[J].实用癌症杂志,2015,30(5):789-790.
[9] Hsieh CY,Tsai HW,Chang CC,et al.Tumors Involving Skin,Soft Tissue and Skeletal Muscle:Benign,Primary Malignant or Metastatic?[J].Asian Pac J Cancer Prev,2016,16(15):6681-6684.
[10] 孙启峰,赵志强,张启文,等.腹腔镜肝部分切除术治疗肝癌患者血清肿瘤标志物的变化[J].实用肝脏病杂志,2018,21(1):121 - 122.
[11] 欧阳正晟,唐朝晖,吕丽娟,等.腹腔镜肝切除与开腹肝切除治疗原发性肝癌的临床比较[J].中国普通外科杂志,2017,26(1):126-130.
[12] Luo X,Wang X,Xia Z,et al.CXCL12/CXCR4 axis:an emerging neuromodulator in pathological pain[J].Rev Neurosci,2016,27(1):83-92.
[13] 杨俊波,黄晓洁.白细胞介素-24通过CXC趋化因子配体12/CXC趋化因子受体4信号轴抑制肿瘤细胞转移[J].中华实验外科杂志,2015,32(10):2465-2468.
[14] Maarschalk J,Robinson SM,White SA.Port site metastases following laparoscopic liver resection for hepatocellular carcinoma[J].Ann R Coll Surg Engl,2015,97(4):e52-53.
[15] 张华,陈旭义,杨波,等.肝细胞肝癌患者血清 micro RNA-224 水平变化及其临床诊断意义的研究V.中国肿瘤临床,2014,41(9):576 - 579.
[16] Ozawa PMM,Ariza CB,Ishibashi CM,et al.Role of CXCL12 and CXCR4 in normal cerebellar development and medulloblastoma[J].Int J Cancer,2016,138(1):10-3.