腹腔镜胆管癌根治术治疗胆管癌患者的临床效果及对肝功能的影响

Clinical effect of laparoscopic radical resection of cholangiocarcinoma in the treatment of patients with cholangiocarcinoma and its influence on liver function

目的探讨腹腔镜胆管癌根治术治疗胆管癌患者的临床效果。方法选取2018年10月至2020年10月本院肿瘤科收治的70例胆管癌患者为研究对象,按随机数字表法将其分为A组和B组,各35例。A组予以经皮肝穿刺胆道造影与引流术(PTBD)介入治疗,B组予以腹腔镜胆管癌根治术。比较两组的治疗效果。结果B组的近期治疗总有效率为82.86%,高于A组的60.00%(P<0.05)。术后24 h,B组的去甲肾上腺素(NE)、皮质醇(Cor)、C反应蛋白(CRP)及白细胞介素-6(IL-6)水平低于A组(P<0.05)。术后7 d,两组的总胆红素(TBil)、碱性磷酸酶(ALP)及丙氨酸氨基转移酶(ALT)水平明显降低,且B组低于A组(P<0.05)。B组的并发症总发生率为8.57%,低于A组的28.57%(P<0.05)。B组的饮食恢复时间、下床活动时间及住院时间均短于A组(P<0.05)。结论腹腔镜胆管癌根治术有助于提升胆管癌患者的近期临床疗效,缓解应激反应,改善肝功能,提升手术安全性。

Objective To investigate the clinical effect of laparoscopic radical resection of cholangiocarci-noma in the treatment of patients with cholangiocarcinoma.Methods A total of 70 patients with cholangioca-rcinoma admitted in the oncology department of our hospital from October 2018 to October 2020 were selected as the research objects.The patients were divided into group A and group B according to random number table method,with 35 cases in each group.The group A was treated with percutaneous transhepatic biliary drainage(PTBD),and the group B was treated with laparoscopic radical resection of cholangiocarcinoma.The therapeutic effects of the two groups were compared.Results The total effective rate of short-term treatment in the group B was 82.86%,which was higher than 60.00%in the group A(P<0.05).At 24 h after operation,the levels of norepinephrine(NE),cortisol(Cor),C-reactive protein(CRP)and interleukin-6(IL-6)in the group B were lower than those in the group A(P<0.05).At 7 d after operation,the levels of total bilirubin(TBil),alkaline phosphatase(ALP)and alanine aminotransferase(ALT)in the two groups significantly decreased,and those in the group B were lower than the group A(P<0.05).The total incidence of complications in the group B was 8.57%,which was lower than 28.57%in the group A(P<0.05).The recovery time of diet,the time of getting out of bed and the time of hospitalization in the group B were shorter than those in the group A(P<0.05).Conclusion Laparoscopic radical resection of cholangiocarcinoma is helpful to improve the short-term clinical efficacy of patients with cholangiocarcinoma,relieve stress response,improve liver function,and improve surgical safety.