自体骨髓干细胞移植辅助肝三叶切除术治疗肝癌的临床研究

目的探讨术前自体骨髓干细胞移植在辅助肝癌肝三叶切除术中的应用。方法选取2005年4月～2010年12月我院肝癌患者行肝三叶切除的19例患者,其中8例在切除肿瘤后术中经肝固有动脉对残肝进行干细胞移植,另外11例行常规肝三叶切除,切除肿瘤后经肝固有动脉仅输入等量生理盐水。分析比较两组肝癌肝三叶切除术后切除率,术后并发症的发生率以及分别在术后第1、2、4周复查肝脏功能,观察肝功能实验室指标、住院时间等。结果干细胞移植辅助肝三叶切除术治疗组术后并发症明显低于对照组,住院时间治疗组为(13±5)d,而对照组为(16±3)d,实验组短于对照组。术后实验组和对照组均有一过性肝功能不全,主要表现为转氨酶升高、清蛋白降低及腹水形成。术后丙氨酸转氨酶、总胆红素、白蛋白和凝血酶原时间实验组优于对照组(P<0.01)。结论自体骨髓干细胞移植辅助肝三叶切除术治疗肝癌有利于患者术后恢复及减少肝功能衰竭等严重并发症。

The application of trisegmentectomy assisted autologous bone marrow stem cells transplantation

Objective To determine the application of trisegmentectomy assisted autologous bone marrow stem cells transplantation.Methods 19 giant liver cancer patients from April 2005 to December 2010 prepared for trisegmentectomy.11 cases were treated by trisegmentectomy alone,8 cases were treated by trisegmentectomy plus autologous bone marrow stem cells transplantation through proper hepatic artery after resection of carcinoma during the operation.Other treatments were the same before and after operation.Results rate,postoperative complications incidence,hospital stays and live function laboratory parameters in first second and fourth weeks were compared and analysed.Results Post operative complications incidence was significant low compared with the control group.Hosiptal stays in abmsct group was(13±5)days while(16±3)days in control group,abmsct group was shorter than control group.A transient of liver disfunction presented in both groups after trisegmentectomy which performed as transaminase rised,Alb decreased and ascites.after trisegmentectomy,ALT,TBIL,Alb and PT superiority existed in abmi group compared with control group(P<0.01).Conclusion The application of trisegmentectomy assisted autologous bone marrow stem cells transplantation is benefit recovery of patients after operation and reduce the incidence of serious complications.