腹腔镜切除术与开腹切除术对原发性肝癌患者外周血T淋巴细胞亚群的影响及临床效果

Effect of laparoscopic hepatectomy and open hepatectomy on T lymphocyte subsets in peripheral blood of patients with primary hepatocellular carcinoma and its clinical effect

目的探讨腹腔镜肝切除与开腹肝切除治疗原发性肝癌的临床疗效。方法将2015年2月—2017年7月宁波市鄞州第二医院收治的120例原发性肝癌患者采用随机数字表法分为A、B两组,各60例。A组行腹腔镜肝切除术,B组行开腹肝切除术,比较2组患者围手术期指标、外周血T淋巴细胞亚群水平变化以及近远期效果。结果A组术中出血量、进食时间、下床时间、住院时间、止痛药用量[(145.48±12.59)mL、(1.65±0.52)d、(4.60±0.78)d、(10.07±1.17)d、(139.24±62.47)mg]均明显低于B组[(202.56±13.68)mL、(2.73±0.75)d、(6.84±0.90)d、(13.22±1.36)d、(282.79±80.01)mg],t=23.782、9.166、14.596、13.601、10.954,均P<0.05。术后1周,A组CD3+、CD4+[(55.33±5.70)、(46.18±7.33)]显著高于B组[(51.97±3.29)、(41.60±6.53)],t=3.955、3.614,均P<0.05,A组CD8+(30.07±3.26)显著低于B组(33.60±3.31),t=5.886,P<0.05。A组并发症率(3.33%)显著低于B组(13.33%),χ^2=3.927,P<0.05。结论相较于开腹肝切除术,腹腔镜肝切除术治疗原发性肝癌效果更佳。

Objective To investigate the clinical effects of laparoscopic hepatectomy and open hepatectomy.Methods A total of 120 patients with primary liver cancer in our hospital from February 2015 to July 2017 were randomly divided into A group and B group by random number method.A group was given laparoscopic hepatectomy,and B group was giv-en open hepatectomy.The perioperative indicators,peripheral blood T lymphocyte subsets,and short-term and long-term effects of two groups were compared.Results The intraoperative blood loss,eating time,getting out bed time,hospital stay,and analgesic dose of A group[(145.48±12.59)mL,(1.65±0.52)d,(4.60±0.78)d,(10.07±1.17)d,(139.24±62.47)mg]were significantly lower than B group[(202.56±13.68)mL,(2.73±0.75)d,(6.84±0.90)d,(13.22±1.36)d,(282.79±80.01)mg],t=23.782,9.166,14.596,13.601 and 10.954,all P<0.05.After one week,the CD3+and CD4+of A group[(55.33±5.70),(46.18±7.33)]were significantly higher than B group[(51.97±3.29),(41.60±6.53)],t=3.955,3.614,all P<0.05,the CD8+of A group(30.07±3.26)was significantly lower than B group(33.60±3.31),t=5.886,P<0.05.The complications incidence of A group(3.33%)was significantly lower than B group(13.33%),χ^2=3.927,P<0.05.Conclusion Compared with open hepatectomy,laparoscopic hepatectomy could effectively treat primary liver cancer.