交替区域入肝血流阻断在原发性肝癌手术治疗中的应用效果及对患者肝功能、营养指标的影响

Effects of Intermittent Regional Hepatic Vascular Inflow Occlusion in the Surgical Treatment of Primary Liver Cancer and Its Influence on Liver Function and Nutritional Index of the Patients

目的:探讨交替区域入肝血流阻断在原发性肝癌手术治疗中的应用效果及对患者肝功能、营养指标的影响。方法:以我院2018年5月至2022年9月收治的70例原发性肝癌患者作为研究对象,依照其手术方式的不同分为观察组与对照组,每组各35例。对照组实施常规肝血流阻断治疗,观察组实施交替区域入肝血流阻断治疗,对比两组患者围术期相关指标、手术前后的肝功能指标、血清营养指标。结果:观察组患者肝血流阻断时间、术中出血量、手术时长、术后首次排气时间和住院时间均低于对照组(P<0.05)。手术前两组患者血清碱性磷酸酶(ALP)、谷丙转氨酶(ALT)、谷草转氨酶(AST)水平比较,差异无统计学意义(P>0.05);手术后两组患者血清ALP、ALT和AST水平较手术前均升高,但观察组患者血清ALP、ALT和AST水平均低于对照组(P<0.05)。手术前,两组患者血清转铁蛋白(TRF)、前白蛋白(PAB)、血清白蛋白(Alb)和血红蛋白(Hb)等营养指标比较,差异无统计学意义(P>0.05);手术后两组患者TRF、PAB、Alb、Hb水平均升高,且观察组患者TRF、PAB、Alb、Hb水平均高于对照组(P<0.05)。结论:与常规肝血流阻断相比,原发性肝癌手术治疗中采取交替区域入肝血流阻断能够减少患者术中出血量和手术时间,促进患者术后康复,而且能够减轻手术对患者肝功能带来的损伤,提升患者术后营养水平。

Objective:To explore the effects of intermittent regional hepatic vascular inflow occlusion in the surgical treatment of primary liver cancer and its influence on liver function and nutritional index of the patients.Methods:70 patients with primary liver cancer admitted to our hospital from May 2018 to September 2022 were selected and were divided into the observation group and the control group according to different surgical methods,with 35 cases in each group.The control group was treated with routine hepatic vascular inflow occlusion during the operation,and the observation group was treated with intermittent regional hepatic vascular inflow occlusion during the operation.The relevant perioperative indexes,liver function indexes before and after surgery,and serum nutritional indexes of the two groups of patients were compared.Results:The time of hepatic vascular inflow occlusion,intraoperative bleeding volume,operation duration,first exhaust time after surgery and hospitalization time of patients in the observation group were lower than those of the control group(P<0.05).Before operation,there was no statistical difference in serum alkaline phosphatase(ALP),glutamic pyruvic transaminase(ALT),and glutamic oxalacetic transaminase(AST)levels between the two groups of patients(P>0.05).After operation,the serum levels of ALP,ALT,and AST of patients in both two groups increased,and the serum ALP,ALT and AST levels of patients in the observation group were lower than those of the control group(P<0.05).Before operation,there was no statistical difference in serum transferrin(TRF),prealbumin(PAB),serum albumin(Alb)and hemoglobin(Hb)levels between the two groups(P>0.05).After operation,the serum TRF,PAB,Alb and Hb levels of patients in both groups increased,and the serum levels of TRF,PAB,Alb and Hb of patients in the observation group were higher than those of the control group(P<0.05).Conclusion:Compared with conventional hepatic vascular inflow occlusion,intermittent regional hepatic vascular inflow occlusion in the surgical treatment of primary liver cancer can reduce intraoperative bleeding,reduce operation duration,promote postoperative recovery of the patients,and reduce the damage caused by surgery to the liver function,improve the postoperative nutritional level of the patients.