腹腔镜肝癌切除术治疗肝细胞癌对患者炎性反应与免疫功能的影响

Effect of Laparoscopic Hepatectomy in Treatment of Hepatocellular Carcinoma on the Inflammatory Reactions and Immune Function

目的观察分析腹腔镜肝癌切除术治疗肝细胞癌对患者炎性反应与免疫功能的影响。方法方便选取2015年1月—2017年12月该院收治的84例肝细胞癌患者为研究对象,随机分为观察组和对照组,各42例。对照组开腹肝癌切除术,观察组腹腔镜肝癌切除术。对比两组患者术中出血量,住院时间,手术前后降钙素原(PCT)、白细胞介素-6(IL-6)、免疫球蛋白A、M、G(IgA、IgM、IgG)水平。结果观察组术中出血量及住院时间明显少于对照组[出血量:(138.13±18.76)mL vs(268.15±31.27)mL;住院时间:(7.16±1.12)d vs(8.46±1.34)d],术后IL-6、PCT水平均低于对照组[IL-6:(12.39±1.67)pg/L vs(19.21±1.59)pg/L;PCT:(6.09±0.67)μg/L vs(9.81±1.12)μg/L],IgA、IgM、IgG水平均高于对照组[lg A:(2.31±0.31)g/L vs(1.61±0.1)g/L;lg M:(1.93±0.21)g/L vs(1.54±0.19)g/L;IgG:(9.69±1.09)g/L vs(6.12±0.73)g/L],均差异有统计学意义(t_(出血量)=23.11,t_(住院时间)=4.82,P<0.05)。结论腹腔镜肝癌切除术治疗肝细胞癌的过程中,对患者免疫功能影响较小,患者产生的炎性反应相对较轻,有利于患者术后康复。

Objective To observe and analyze the effect of laparoscopic hepatectomy in treatment of hepatocellular carcinoma on the inflammatory reactions and immune function. Methods 84 cases of patients with hepatocellular carcinoma admitted and treated in our hospital from January 2015 to December 2017 were conveniently selected and randomly divided into two groups with 42 cases in each, the control group and the observation group were respectively treated with resection of hepatoma by laparotomy and laparoscopic hepatectomy, and the intraoperative bleeding amount, length of stay and PCT, IL-6 and IgA, IgM,IgG levels before and after surgery were compared. Results The intraoperative bleeding amount and length of stay in the observation group were obviously lower than those in the control group, [bleeding amount：（138.13±18.76）mL vs（268.15±31.27）mL; the length of stay：（7.16±1.12） d vs（8.46±1.34）d, and the postoperative IL-6 and PCT levels after surgery were lower than those in the control group [IL-6：（12.39±1.67）pg/L vs（19.21±1.59） pg/L; PCT：（6.09±0.67） μg/L vs（9.81±1.12）μg/L], and the IgA, IgM, IgG levels were higher than those in the control group [IgA：（2.31±0.31）g/L vs（1.61±0.1）g/L;IgM：（1.93±0.21） g/L vs（1.54±0.19）g/L; Ig G：（9.69±1.09）g/L vs（6.12±0.73）g/L], and the differences were obvious（t（出血量）=23.11,（t（住院时间）=4.82,P0.05）. Conclusion The effect of laparoscopic hepatectomy in treatment of hepatocellular carcinoma on the inflammatory reactions and immune function is small, which is conductive to the postoperative recovery.