抗病毒治疗对行根治切除术肝癌合并乙肝病毒感染患者的应用价值

Application value of antiviral therapy for liver cancer patients infected with hepatitis B virus undergoing radical resection

目的:探讨抗病毒治疗对行根治切除术的肝癌合并乙肝病毒(HBV)感染患者的意义。方法:将60例行根治性切除术的肝癌患者按HBV-DNA水平区分为高病毒复制组(HBV-DNA载量≥105拷贝/mL)与低病毒复制组(HBV-DNA载量<105拷贝/mL),分别比较各自组内行阿德福韦酯抗病毒治疗与未行抗病毒治疗患者间术后肝功能、HBV-DNA水平、并发症发生率、住院天数及费用等。结果:无论是高病毒复制组还是低病毒复制组,行抗病毒治疗患者肝功能恢复均优于无抗病毒治疗患者,且HBV-DNA水平较无抗病毒治疗的患者明显降低,差异均有统计学意义(均P<0.05);两组中行抗病毒治疗患者的术后并发症、住院时间及费用均低于各自组中无抗病毒治疗的患者,其中术后并发症发生率差异在低病毒复制组中有统计学意义,住院时间及费用差异在高病毒复制组中有统计学意义(均P<0.05)。结论:抗病毒治疗能明显改善肝癌合并HBV感染患者术后的肝功能和病毒学指标,具有一定的应用价值。

Objective： To assess the significance of antiviral therapy in liver cancer patients infected with hepatitis B virus（HBV） undergoing radical resection. Methods： Sixty patients undergoing radical resection for liver cancer were divided into high-level viral replication group（load level of HBV-DNA≥105 copies/mL） and low-level viral replication group（load level of HBV-DNA105 copies/mL）,according to their HBV-DNA levels.The postoperative liver function,HBV-DNA levels and incidence of complications as well as length of hospital stay and costs between patients receiving antiviral therapy with adefovir dipivoxil and those who did not were compared within each group. Results： In either high-level viral replication group or low-level viral replication group,patients with antiviral treatment had better recovery of liver function and lower HBV-DNA levels than those without antiviral treatment,and all differences reached a statistical significance（all P0.05）;in either group,the incidence of postoperative complications was decreased and length of hospital stay and costs was reduced in patients who received antiviral treatment compared with those without antiviral treatment,and difference in incidence of postoperative complications in low-level viral replication group reached statistical significance while difference in length of hospital stay and costs in high-level viral replication group achieved statistical significance（all P0.05）. Conclusion： Antiviral therapy can effectively improve the postoperative liver function and virological indexes of liver cancer patients,so it has certain value in clinical practice.