两种方法治疗原发性肝癌的疗效及其对C-反应蛋白和凝血功能的影响

目的探讨腹腔镜规则肝叶切除和开腹治疗原发性肝癌（HCC）的疗效及其对c_反应蛋白（CRP）和凝血功能的影响。方法将56例HCC患者分为腹腔镜组和开腹组，每组各28例。比较两种手术方式的临床疗效及CRP和凝血功能指标的变化。结果腹腔镜组总有效率为89．28％，显著优于开腹组的42．86％，差异有统计学意义（P〈0．05）；术中腹腔镜组平均出血量、术后平均禁食时间、平均腹腔引流时间、平均住院时间、并发症发生率均明显少于开腹组，差异有统计学意义（P〈0．05）；术后两组患者的CRP、血小板计数、活化部分凝血活酶时间和凝血酶时间均呈现不同程度下降，差异有统计学意义（P〈0．05）；腹腔镜组上述指标的改善程度明显优于与开腹组，差异有统计学意义（P〈0．05）；腹腔镜组1年生存率亦显著高于开腹组，差异有统计学意义（P〈0．05）。结论与传统开腹手术相比，腹腔镜规则肝叶切除术是治疗HCC的有效微创方法，CRP和凝血功能是其潜在的生物标志。

Clinical efficiency of laparoscopic hepatectomy and laparotomy treatment with HCC and their impact on the C-reactive protein and coagulation function

Objective To explore the clinical efficiency of laparoscopie hepatectomy and laparotomy treatment with HCC and their impact on the C-reactive protein（CRP） and coagulation function. Methods Fifty six cases with HCC patients were divided into laparoscopic group and laparotomy group, twenty eight cases in each group. Clinical efficacy,CRP and coagulation indicators from the two groups were compared. Results The overall effective rate of Laparoscopic group was 89.28 ~ ,which was significantly better than 42.86 % of laparotomy group（P〈0.05） ;Mean intraoperative blood loss, postoperative mean fasting time, average peritoneal drainage time, average length of stay, in- cidence of complications were significantly less than the laparotomy group（P〈0.05） ;The CRP, PLT, APTT and TT indicators in two groups were declined after surgery（P〈0.05） ;The degree of improvement of these indicators in lap- aroscopic group was significantly better than laparotomy group（P〈0.05）;One-year survival rate of laparoscopic group was also significantly higher than the laparotomy group（P〈0.05）. Conclusion Compared with the traditional laparotomy,laparoscopie hepatectomy is an effective minimally invasive approach for the treatment of HCC, and CRP and coagulation parameters could be its potential biomarkers.