前入路肝右半切除术在肝癌中的应用价值

Application value of anterior right hepatectomy in the treatment of liver cancer

目的探讨前入路肝右半切除术在肝癌中的应用价值。方法根据治疗方式的不同将65例肝癌患者分为对照组(n=32)和观察组(n=33),对照组患者给予常规入路肝切除术治疗,观察组患者给予前入路肝切除术治疗。比较两组患者的手术相关指标、炎症因子[白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α),计算中性粒细胞与淋巴细胞比值(NLR)]、肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)]和术后并发症发生情况。结果观察组患者平均出血量少于对照组(P﹤0.05),输血率和肿瘤破裂率均低于对照组(P﹤0.05),住院时间短于对照组(P﹤0.05)。术后7天,两组患者IL-6、TNF-α、IL-8水平和NLR均高于本组术前(P﹤0.05),但观察组患者IL-6、TNF-α、IL-8水平和NLR均低于对照组(P﹤0.05)。术后7天,两组患者AST、ALT水平均高于本组术前(P﹤0.05),但观察组患者AST、ALT水平均低于对照组(P﹤0.05)。两组患者腹腔感染、腹腔出血、胆瘘、肺部感染并发症发生率均无明显差异(P﹥0.05)。结论前入路右半肝切除术可有效减轻肝癌患者的炎症反应,改善肝功能指标,促进术后恢复。

Objective To investigate the application value of anterior right hepatectomy in the treatment of liver cancer.Method According to different treatment methods,65 patients with liver cancer were divided into control group(n=32)and observation group(n=33).The patients in the control group were treated with conventional approach hepatectomy,and the patients in the observation group were treated with anterior approach hepatectomy.The operation-related indexes,inflammatory factor[interleukin-6(IL-6),interleukin-8(IL-8)、tumor necrosis factor-α(TNF-α),and calculate neutrophil-to-lymphocyte ratio(NLR)],liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST)]and postoperative complications were compared between the two groups.Result The average blood loss in the observation group was less than that in the control group(P<0.05),the blood transfusion rate and tumor rupture rate were lower than those in the control group(P<0.05),and the length of hospital stay was shorter than that in the control group(P<0.05).7 days after operation,the IL-6,TNF-α,IL-8 and NLR were higher than those before operation(P<0.05),but the levels of IL-6,TNF-α,IL-8 and NLR in the observation group were lower than those in the control group(P<0.05).7days after operation,the levels of AST and ALT in the two groups were higher than those before operation(P<0.05),but the levels of AST and ALT in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of complications such as intra-abdominal infection,intra-abdominal hemorrhage,biliary fistula,and pulmonary infection between the two groups(P>0.05).Conclusion Anterior right hepatectomy can effectively reduce the inflammatory response in patients with liver cancer,improve liver function indicators,and promote postoperative recovery.