腹腔镜胆管癌根治术对胆管癌患者的治疗效果

Effect of laparoscopic radical resection on patients with cholangiocarcinoma

目的探讨腹腔镜胆管癌根治术对胆管癌患者的治疗效果。方法根据治疗方式的不同将270例胆管癌患者分为对照组(n=200)和观察组(n=70),对照组患者采取经皮经肝胆道引流介入治疗,观察组患者采取腹腔镜胆管癌根治术,两组患者均予以预见性干预。比较两组患者的临床疗效、应激反应指标[皮质醇(Cor)、白细胞介素-6(IL-6)、去甲肾上腺素(NE)]、肝功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)]及并发症发生情况。结果观察组患者的疾病控制率为95.71%,高于对照组患者的87.00%,差异有统计学意义(P﹤0.05)。术后48 h,两组患者的血清Cor、NE、IL-6水平均高于本组术前,差异均有统计学意义(P﹤0.05);术后48 h,两组患者的血清Cor、NE、IL-6水平比较,差异均无统计学意义(P﹥0.05)。术后7天,两组患者的血清ALT、AST、TBIL水平均低于本组术前,观察组患者的血清ALT、AST、TBIL水平均低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的并发症总发生率为8.57%,低于对照组患者的20.50%,差异有统计学意义(P﹤0.05)。结论腹腔镜胆管癌根治术治疗胆管癌患者可提高疾病控制率,改善患者的肝功能且安全性较高。

Objective To investigate the therapeutic effect of laparoscopic radical resection on patients with cholangiocarcinoma.Method A total of 270 patients with cholangiocarcinoma were divided into control group(n=200)and observation group(n=70)according to the different treatment methods.Patients in the control group were treated with percutaneous transhepatic biliary drainage interventional therapy,patients in the observation group were treated with laparoscopic radical resection of cholangiocarcinoma,and patients in both groups received predictive intervention.The clinical efficacy,stress response indicators[cortisol(Cor),interleukin-6(IL-6),norepinephrine(NE)],liver function indicators[alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL)]and complications were compared between the two groups.Result The disease control rate of the observation group was 95.71%,which was higher than 87.00%of the control group,and the difference was statistically significant(P<0.05).At 48 hours after the operation,the levels of serum Cor,NE,and IL-6 in the two groups were higher than those before the operation,and the differences were statistically significant(P<0.05).At 48 hours after the operation,there were no significant differences in serum Cor,NE,and IL-6 levels between the two groups(P>0.05).Seven days after the operation,the serum levels of ALT,AST,and TBIL in the two groups were lower than those before the operation,the serum levels of ALT,AST,and TBIL in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was 8.57%,which was lower than 20.50%in the control group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic radical resection of cholangiocarcinoma could improve the disease control rate and liver function of cholangiocarcinoma patients with high safety.