血清HBV-DNA载量与肝细胞癌患者手术风险的临床关系

发布时间：2018-06-23 04:30

本文选题：癌 + 肝细胞　；参考：《中国普通外科杂志》2017年07期

【摘要】：目的:探讨肝细胞癌患者血清中乙肝病毒的脱氧核糖核酸(HBV-DNA)载量与肝细胞癌患者手术风险的临床关系。方法:回顾性分析2013年7月—2015年7月收治的86例肝细胞癌患者的临床资料,根据术前HBVDNA载量将患者分为低复制组(40例)和高复制组(46例),比较两组患者围手术期临床资料,分析HBV-DNA载量与手术风险的相关性。结果:高复制组在麻醉时间、手术时间、术中出血量水平高于低复制组,半阻断例数高于低复制组,但差异无统计学意义(P0.05),住院时间较低复制组显著延长(P0.05);术后1 d两组患者ALT、AST均较术前显著升高(P0.05),且高复制组显著高于低复制组(P0.05),术后3、7 d两组ALT、AST水平均下降,且高复制组下降幅度显著高于低复制组(P0.05),两组患者术后1、3、7 d TBIL水平较术前无明显变化(P0.05),且组间差异无统计学意义(P0.05);低复制组并发症发生率显著低于高复制组(P0.05)。低复制组并发症Clavien-Dindo分级低于高复制组,差异有统计学意义(P0.05)。结论:术前肝细胞癌患者血清HBV-DNA载量越高,围手术期肝功能恢复时间长,住院时间延长,且并发症发生率高,手术相关风险较大。
[Abstract]:Objective: to investigate the relationship between serum HBV DNA load and surgical risk in patients with hepatocellular carcinoma (HCC). Methods: the clinical data of 86 patients with hepatocellular carcinoma from July 2013 to July 2015 were retrospectively analyzed. According to the HBV DNA load before operation, the patients were divided into low replication group (40 cases) and high replication group (46 cases). To analyze the correlation between HBV-DNA load and surgical risk. Results: in the high replication group, the anesthetic time, the operation time, the intraoperative bleeding volume were higher than those in the low copy group, and the number of semi-blocking cases was higher than that in the low replication group. But the difference was not statistically significant (P0.05), the hospitalization time was significantly longer than that of the low replication group (P0.05), the alt of the two groups was significantly higher than that of the pre-operation on the 1st day after operation (P0.05), and the level of alt in the high replication group was significantly higher than that in the low replication group (P0.05), and the alt AST level in the two groups decreased 3 days after operation. The decrease of TBIL in the high replication group was significantly higher than that in the low replication group (P0.05). There was no significant change in TBIL level between the two groups on the 1st and 7th day after operation (P0.05), and there was no significant difference between the two groups (P0.05), and the incidence of complications in the low replication group was significantly lower than that in the high replication group (P0.05). The complication Clavien-Dindo grade of low replication group was lower than that of high replication group, the difference was statistically significant (P0.05). Conclusion: the higher the serum HBV-DNA load, the longer the recovery time of liver function, the longer the hospital stay, the higher the incidence of complications and the higher the risk of operation.
【作者单位】：宁夏医科大学总医院感染疾病科;宁夏医科大学总医院肝胆外科;
【分类号】：R735.7

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