精准肝切除与常规肝切除对肝癌患者T细胞亚群变化影响的比较

发布时间：2018-03-26 02:40

本文选题：癌　切入点：肝细胞　出处：《中国普通外科杂志》2017年07期

【摘要】：目的:比较精准肝切除与常规肝切除对肝癌患者T细胞亚群变化的影响。方法:将47例肝癌患者随机分为两组,分别行精准肝切除术(精准肝切除组,26例)和常规肝切除术(常规肝切除组,21例)。比较两组主要临床指标,及手术前后外周血CD3~+、CD4~+、CD8~+及CD4~+/CD8~+水平。结果:与常规肝切除组比较,精准肝切除组手术时间延长,但失血量少、住院时间短、术后胆汁漏与腹腔出血发生率低(均P0.05);精准肝切除组术后肝功能指标的变化优于常规肝切除组(均P0.05)。术后7 d,两组CD3~+、CD4~+及CD4~+/CD8~+水平均较术前明显下降,但精准肝切除组下降程度明显小于常规肝切除组(均P0.05),两组CD8~+水平均较术前略有升高(均P0.05);术后14 d,两组各T细胞亚群均恢复至术前水平。结论:精准肝切除在术后免疫功能的保护方面优于常规肝切除,从而有利于肝癌患者肝脏功能的恢复。
[Abstract]:Objective: to compare the effects of accurate hepatectomy and routine hepatectomy on the changes of T cell subsets in patients with hepatocellular carcinoma. Methods: 47 patients with liver cancer were randomly divided into two groups. The main clinical parameters of the two groups were compared, and the levels of CD3 ~ + CD4 ~ + CD8 ~ and CD4 ~ / CD8 ~ ~ in peripheral blood before and after operation were compared between the two groups. Results: compared with the routine hepatectomy group, In the accurate hepatectomy group, the operative time was prolonged, but the blood loss was less and the hospitalization time was short. The incidence of postoperative bile leakage and intraperitoneal hemorrhage was lower (all P 0.05), and the changes of liver function in accurate hepatectomy group were better than those in routine hepatectomy group (P 0.05). On the 7th day after operation, the levels of CD3 ~ + CD4 ~ and CD4 ~ / / CD8 ~ in both groups were significantly lower than those before operation. However, the degree of decrease in the precision hepatectomy group was significantly lower than that in the conventional hepatectomy group (all P 0.05). The CD8- ~ level in both groups was slightly higher than that in the preoperative group (P 0.05), and on the 14th day after operation, the T cell subsets in the two groups returned to the preoperative level. The protection of immune function after operation is superior to that of routine hepatectomy. It is beneficial to the recovery of liver function in patients with liver cancer.
【作者单位】：昆明医科大学第二附属医院肝胆胰外科一病区;
【基金】：云南省卫生厅内设研究机构基金资助项目(2016ns249) 云南省教育厅科学研究基金资助项目(2015C042Y)
【分类号】：R735.7

【相似文献】