腹腔镜肝癌切除术对肝癌患者转氨酶、FGF及淋巴细胞的影响

The Effects of Laparoscopic Hepatectomy on Transaminase,FGF and Lymphocytes in Patients with Hepatocellular Carcinoma

目的研究腹腔镜及开腹肝癌切除术治疗前后患者血清转氨酶、FGF水平及淋巴细胞变化及其临床意义。方法将2016年8月至2018年8月我院94例择期手术的HCC患者根据不同手术方式分为两组,分别在完善相关检查后进行手术治疗,其中行腹腔镜手术者53例为观察组,行开腹手术者41例为对照组,比较两组术后手术相关指标、转氨酶、血清FGF水平及T淋巴细胞亚群分布情况。结果观察组切口大小、术中出血量、首次进食时间、引流时间、住院时间及并发症发生率均明显少于对照组,差异有统计学意义(P <0. 05);术后第3d两组血清ALT、AST、TBIL、CD4^+及CD4^+/CD8^+水平均明显升高(P<0.05),血清ALB、CD3^+及CD8^+水平明显降低(P<0.05),且观察组血清ALT、AST、TBIL、CD4^+及CD4^+/CD8^+水平高于对照组,血清ALB、CD3^+及CD8^+水平低于对照组,差异有统计学意义(P <0. 05);两组血清aFGF及bFGF水平均明显降低(P <0.05),且两组间比较无明显差异(P>0.05)。结论患者血清转氨酶、FGF及T淋巴细胞亚群分布等指标与HCC病情关系密切,且在腹腔镜肝癌切除术后均获得明显改善,因此可用于评价肝癌手术治疗效果并监测术后复发或转移情况。

Objective To study the changes of serum transaminase,FGF and lymphocytes and their clinical significances before and after laparoscopic and open hepatectomy.Methods 94 cases of patients with HCC who underwent elective surgery from August,2016 to August,2018 were divided into two groups according to different surgical methods.These patients were given surgical treatment after completing relevant examinations.Among them,53 patients with laparoscopic surgery were included in the observation group,and 41 patients with open surgery were selected as the control group.The postoperative operation-related indexes,transaminase,serum FGF level and distribution of T lymphocyte subsets were compared between the two groups.Results The incision size,intraoperative blood loss,initial feeding time,drainage time,hospital stay and incidence rate of complications in the observation group were significantly lower than those in the control group (P <0.05).The levels of ALT,AST,TBIL,CD4^+ and CD4^+/CD8^+ were significantly increased in the two groups at 3d after the operation (P <0.05),while the levels of serum ALB,CD3^+ and CD8^+ were significantly decreased (P <0.05).The levels of serum ALT,AST,TBIL,CD4^+ and CD4^+/CD8^+ in the observation group were higher than those in the control group,while the levels of serum ALB,CD3^+ and CD8^+ were lower than those in the control group (P <0.05).Serum aFGF and bFGF levels were both significantly decreased in the two groups (P <0.05),and there were no significant differences between the two groups(P >0.05).Conclusion Serum transaminase,FGF and distribution of T lymphocyte subsets are closely related to HCC,and they are significantly improved after laparoscopic hepatectomy.Therefore,these markers can be used to evaluate the treatment effects of liver cancer surgery and to monitor postoperative recurrence or metastasis.