腹腔镜和开腹再次肝切除术治疗复发性肝细胞癌的效果及对肝功能的影响研究

Effect of Laparoscopic and Open Rehepatectomy in the Treatment of Recurrent Hepatocellular Carcinoma and Its Effect on Liver Function

目的:对比腹腔镜和开腹再次肝切除术治疗复发性肝细胞癌的效果及对肝功能的影响。方法:选取2018年12月-2019年12月经笔者所在医院确诊的100例复发性肝细胞癌患者。根据手术方式的不同将其分为对照组和研究组,每组50例。对照组行开腹再次肝切除术,研究组在腹腔镜下行再次肝切除术。比较两组手术指标、治疗前后肝功能指标、术后不同时间VAS评分、治疗前后免疫功能指标水平。结果:研究组手术时间、术中出血量、排气时间、下床活动时间均优于对照组,差异有统计学意义(P<0.05)。治疗前,两组肝功能指标比较差异均无统计学意义(P>0.05);治疗后两组肝功能指标均有所改善,且研究组改善程度优于对照组,差异有统计学意义(P<0.05)。研究组术后1、3、7 d的VAS评分均低于对照组,差异有统计学意义(P<0.05)。治疗前,两组免疫功能指标比较差异均无统计学意义(P>0.05);治疗后两组免疫功能指标均有所改善,且研究组改善程度优于对照组,差异有统计学意义(P<0.05)。结论:采用腹腔镜下再次肝切除术治疗复发性肝细胞癌的效果较开腹手术更为理想,患者临床指标改善效果更佳,因此可在临床推广应用。

Objective:To compare the effect of laparoscopic and open rehepatectomy in the treatment of recurrent hepatocellular carcinoma and its effect on liver function.Method:A total of 100 patients with recurrent hepatocellular carcinoma diagnosed in our hospital from December 2018 to December 2019 were selected.They were divided into the control group and the study group according to the different surgical methods,with 50 cases in each group.The control group underwent open rehepatectomy,while the study group underwent laparoscopic rehepatectomy.The operation indexes,liver function indexes before and after treatment,VAS scores at different times after surgery and immune function indexes levels before and after treatment were compared between the two groups.Result:The operation time,intraoperative bleeding volume,exhaust time,and time of getting out of bed activity in the study group were all better than those in the control group,the differences were statistically significant (P<0.05).Before treatment,there were no statistically significant differences in liver function indexes between the two groups (P>0.05).After treatment,liver function indexes of the two groups were improved,and the improvement degree of the study group was better than that of the control group,the differences were statistically significant (P<0.05).The VAS scores of the study group at 1,3 and 7 days after surgery were lower than those of the control group,the differences were statistically significant (P<0.05).Before treatment,there were no significant differences in immune function indexes between the two groups (P>0.05).After treatment,the immune function indexes of the two groups were improved,and the improvement degree of the study group was better than that of the control group,the differences were statistically significant (P<0.05).Conclusion:The effect of laparoscopic rehepatectomy in the treatment of recurrent hepatocellular carcinoma is better than that of open surgery,and the improvement of clinical indexes is better,so it can be widely used in clinical practice.