腹腔镜切除术与肝动脉化疗栓塞术治疗复发性肝癌的对比分析

Comparative analysis of laparoscopic resection and hepatic artery chemoembolization in the treatment of recurrent hepatocellular carcinoma

目的探讨腹腔镜切除术与肝动脉化疗栓塞术(TACE)治疗复发性肝癌的对比分析。方法回顾分析我院2017年3月至2020年1月收治的复发性肝癌患者92例作为研究对象,根据治疗方法不同将其分为TACE组(n=71)与腔镜肝切组(n=21),TACE组予以TACE术治疗,腔镜肝切组予以腹腔镜下肝癌切除术治疗,对比两组手术相关指标、细胞免疫功能、炎症因子C反应蛋白(CRP)、白细胞介素-8(lL-8)、肿瘤坏死因子(TNF-α)及白细胞介素-1β(IL-)水平、并发症及生存情况。结果TACE组患者手术时间、术后疼痛药物使用时间、首次进食时间及住院天数均明显低于腔镜肝切组(P<0.05);术后5d,TACE组患者CD3、CD4、CD4/CD8及NK均明显高于腔镜肝切组,而CD8明显低于腔镜肝切组(P<0.05);TACE组患者CRP、IL-8、TNF-α及IL-1β水平均低于腔镜肝切组(P<0.05);TACE组和腔镜肝切组总并发症发生率和存活率对比无明显差异(P>0.05)。结论腹腔镜下肝癌切除术与TACE术对肝癌患者均有一定临床疗效,两者安全性、及并发症少。但TACE更适合难以手术的复发性肝癌患者,主要表现在改善机体免疫功能效果更为显著,故TACE在复发性肝癌治疗中临床应用价值更高。

Objective To investigate the comparative analysis of laparoscopic resection and hepatic artery chemoembolization in the treatment of recurrent hepatocellular carcinoma.Methods Retrospective analysis of our hospital in March 2017 to January 2020,92 patients with recurrent liver cancer as the research object,according to different will be divided into the conventional treatment group(n=71)and liver cavity mirror group(n=21),group with conventional treatment with conventional,liver group of cavity mirrors to laparoscopic resection of liver cancer treatment,compared two groups of indicators related to the operation,cellular immune function and inflammatory factor C reactive protein(CRP)and interleukin 8(IL-8),tumor necrosis factor(TNF alpha)and interleukin 1 beta(IL-)levels,complications and survival conditions.Results The operative time,postoperative pain medication use time,first feeding time and length of hospital stay in THE TACE group were significantly lower than those in the laparoscopic hepatec-tomy group(P<0.05).5 days after surgery,CD3,CD4,CD4/CD8 and NK in the TACE group were significantly higher than those in the laparoscopic hepatectomy group,while CD8 was significantly lower than that in the laparoscopic hepatectomy group(P<0.05).The levels of CRP,IL-8,TNF- and IL-1 in the TACE group were all lower than those in the laparoscopic hepatectomy group(P<0.05).There was no significant difference in the total complication rate and survival rate between the TACE group and the laparoscopic hepatectomy group(P>0.05).Conclusion Both laparoscopic hepatocellular carcinoma resection and TACE have certain clinical efficacy in patients with liver cancer,with fewer safety and complications.However,TACE is more suitable for patients with recurrent liver cancer that is difficult to operate,mainly manifested by more significant effects in improving the immune function of the body.Therefore,TACE has higher clinical application value in the treatment of recurrent liver cancer.