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中华普外科手术学杂志(电子版) ›› 2018, Vol. 12 ›› Issue (05) : 382 -384. doi: 10.3877/cma.j.issn.1674-3946.2018.05.009

所属专题: 文献

论著

3D/2D腹腔镜根治术与开腹术治疗原发性肝癌的疗效及细胞免疫变化比较
杨成林1, 张书培1,()   
  1. 1. 725000 陕西,安康市中心医院
  • 收稿日期:2018-05-28 出版日期:2018-10-26
  • 通信作者: 张书培

Comparative investigation of curative effect and cellular immunity of patients with primary liver cancer underwent 3D/2D laparoscopic or laparotomic radical resection

Chenglin Yang1, Shupei Zhang1,()   

  1. 1. Ankang City Central Hospital, Shaanxi 725000, China
  • Received:2018-05-28 Published:2018-10-26
  • Corresponding author: Shupei Zhang
  • About author:
    Corresponding Author: Zhang Shupei, Email:
引用本文:

杨成林, 张书培. 3D/2D腹腔镜根治术与开腹术治疗原发性肝癌的疗效及细胞免疫变化比较[J/OL]. 中华普外科手术学杂志(电子版), 2018, 12(05): 382-384.

Chenglin Yang, Shupei Zhang. Comparative investigation of curative effect and cellular immunity of patients with primary liver cancer underwent 3D/2D laparoscopic or laparotomic radical resection[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2018, 12(05): 382-384.

目的

比较3D/2D腹腔镜根治术与开腹术治疗原发性肝癌的疗效及细胞免疫变化。

方法

回顾性分析2013年7月至2015年5月原发性肝癌患者90例资料,根据手术方式不同分为开腹组、2D组及3D组。采用SPSS19.0软件进行统计分析,其中手术指标与免疫指标等采用(±s)描述,两组间采用t检验,三组间采用F检验;术后并发症及术后复发、转移、生存情况等采用χ2检验。P<0.05差异有统计学意义。

结果

2D组与3D组的肛门排气时间均明显低于开腹组(P<0.05);3D组的手术时间低于2D组(P<0.05),与开腹组无差异(P>0.05);3D组的术中出血量与术后住院时间均低于2D组、开腹组(P<0.05),三组患者术后并发症、术后36个月复发、转移与死亡的发生率差异无统计学意义(P>0.05);开腹组与2D组患者的NK细胞、CD4细胞的百分比以及CD4/CD8值均明显低于术前,而CD8细胞百分比则明显高于术前(P<0.05);手术前后3D组患者的各项免疫功能指标差异无统计学意义(P>0.05)。

结论

3D腹腔镜根治术治疗原发性肝癌疗效显著,临床应用安全可靠,对患者的免疫功能影响更小,值得进一步推广。

Objective

To explore the curative effect and cellular immunity of patients with primary liver cancer underwent 3D/2D laparoscopic or laparotomic radical resection.

Methods

Retrospective analysis were performed in 90 patients with primary liver cancer from July 2013 to May 2015, who were divided into open group, 2D group and 3D group according to the different surgical methods. Statistical analysis were performed by using SPSS 19.0 software, Measurement data, such as operation and immune function indicators, were expressed as ±s, and were examined by using t test and F test. Count data such as postoperative complications, reccurence, metastasis and survival were examined by chi square test. A P value <0.05 was considered as statistically significant difference.

Results

The anus exhaust time of 2D group and 3D group were significantly lower than that iof open group (P<0.05); The operation time of 3D group was lower than that of 2D group (P<0.05), with no difference between 3D group and open group (P>0.05). The intraoperative blood loss and postoperative hospital stay of 3D group were lower than those of 2D group and open group respectively (P<0.05). There was no significant difference in terms of incidence of postoperative complications, recurrence, metastasis and death between three groups (P>0.05). The percentage of NK cells, CD4+ cells, and CD4+ /CD8+ values of laparotomy group and 2D group were significantly lower than those before surgery, and the percentage of CD8+ cells was significantly higher than those before surgery respectively (P<0.05); There were no significant differences in terms of immune function indicators of 3D group before and after surgery (P>0.05).

Conclusion

Curative effect of primary liver cancer by 3D laparoscopic radical resection is convincing. It is safe and reliable in clinical application with less impact on the patient’s immune function and is worth further promotion.

表1 90例原发性肝癌患者不同术式三组患者的基本临床资料(±s,例)
表2 90例原发性肝癌不同术式三组患者手术指标比较(±s)
表3 90例原发性肝癌不同术式三组患者的术后并发症情况比较(例次)
表4 90例原发性肝癌不同术式三组患者的术后复发、转移与生存比较[例(%)]
表5 90例原发性肝癌不同术式三组患者术后7 d免疫功能比较免疫功能比较(±s)
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