二种手术方法治疗原发性肝癌的疗效及趋化因子12水平比较

目的研究完全腹腔镜根治术与开腹术治疗原发性肝癌的疗效及趋化因子12动态变化。 方法回顾性分析2015年5月至2017年10月期间接受诊治的92例原发性肝癌患者临床资料，根据患者手术方式不同分成开腹组43例(开腹手术)、腹腔镜组49例(完全腹腔镜根治术)。采用SPSS20.0统计学软件，术后恢复情况、手术前后趋化因子12动态变化计量资料采用 ±s表示，独立t检验；术后并发症发生率采用χ²检验；以P<0.05为差异有统计学意义。 结果腹腔镜组术后并发症发生率、术后引流管留置时间、术后首次进食时间、术后住院时间均低于开腹组(P<0.05)；随着术后恢复时间增加，两组趋化因子12的表达水平逐渐降低(P<0.05)，腹腔镜组术后1 d、3 d、7 d趋化因子12水平均低于开腹组(P<0.05)；腹腔镜组术后7 d趋化因子12降至正常水平。 结论完全腹腔镜根治术治疗原发性肝癌疗效确切，术后并发症发生率低，术后恢复快，能减轻机体炎症反应。

Comparison of efficacy of two surgical procedures in treatment of primary liver cancer and changes of chemokine 12 levels

ObjectiveTo study the efficacy of total laparoscopic radical surgery and open surgery in treatment of primary liver cancer and its influence on dynamic changes of chemokine 12. MethodsThe clinical data of 92 patients with primary liver cancer in our hospital from May 2015 to October 2017 were retrospectively analyzed. All the patients were divided into 43 cases of open group (open surgery) and 49 cases of laparoscopic group (total laparoscopic radical surgery) by surgical procedures. SPSS20.0 statistical software was adopted, the measurement data of postoperative recovery, dynamic changes of chemokine 12 before and after surgery were expressed by ( ±s), and independent t test was adopted; The incidence of postoperative complications was measured by χ² test; P<0.05 was considered statistically significant. ResultsThe incidence of postoperative complications, postoperative drainage tube indwelling time, postoperative first feeding time, postoperative hospital stays in laparoscopic group were lower than those in open group (P<0.05); The chemokine 12 expression levels in two groups gradually decreased as postoperative recovery time increased (P<0.05), and the postoperative 1 d, 3 d, 7 d chemokine 12 levels in laparoscopic group were lower than those in open group (P<0.05); There was no statistical difference in the postoperative 7 d chemokine 12 level between laparoscopic group and healthy group (P>0.05). ConclusionTotal laparoscopic radical surgery in treatment of primary liver cancer is effective, it can achieve low incidence of postoperative complications and quicj postoperative recovery, and the chemokine 12 level quickly decreases.