本文選題：癌 + 肝細(xì)胞��； 參考：《中國(guó)普通外科雜志》2017年07期

【摘要】：目的:探討肝細(xì)胞癌患者血清中乙肝病毒的脫氧核糖核酸(HBV-DNA)載量與肝細(xì)胞癌患者手術(shù)風(fēng)險(xiǎn)的臨床關(guān)系。方法:回顧性分析2013年7月—2015年7月收治的86例肝細(xì)胞癌患者的臨床資料,根據(jù)術(shù)前HBVDNA載量將患者分為低復(fù)制組(40例)和高復(fù)制組(46例),比較兩組患者圍手術(shù)期臨床資料,分析HBV-DNA載量與手術(shù)風(fēng)險(xiǎn)的相關(guān)性。結(jié)果:高復(fù)制組在麻醉時(shí)間、手術(shù)時(shí)間、術(shù)中出血量水平高于低復(fù)制組,半阻斷例數(shù)高于低復(fù)制組,但差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),住院時(shí)間較低復(fù)制組顯著延長(zhǎng)(P0.05);術(shù)后1 d兩組患者ALT、AST均較術(shù)前顯著升高(P0.05),且高復(fù)制組顯著高于低復(fù)制組(P0.05),術(shù)后3、7 d兩組ALT、AST水平均下降,且高復(fù)制組下降幅度顯著高于低復(fù)制組(P0.05),兩組患者術(shù)后1、3、7 d TBIL水平較術(shù)前無(wú)明顯變化(P0.05),且組間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);低復(fù)制組并發(fā)癥發(fā)生率顯著低于高復(fù)制組(P0.05)。低復(fù)制組并發(fā)癥Clavien-Dindo分級(jí)低于高復(fù)制組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:術(shù)前肝細(xì)胞癌患者血清HBV-DNA載量越高,圍手術(shù)期肝功能恢復(fù)時(shí)間長(zhǎng),住院時(shí)間延長(zhǎng),且并發(fā)癥發(fā)生率高,手術(shù)相關(guān)風(fēng)險(xiǎn)較大。
[Abstract]:Objective: to investigate the relationship between serum HBV DNA load and surgical risk in patients with hepatocellular carcinoma (HCC). Methods: the clinical data of 86 patients with hepatocellular carcinoma from July 2013 to July 2015 were retrospectively analyzed. According to the HBV DNA load before operation, the patients were divided into low replication group (40 cases) and high replication group (46 cases). To analyze the correlation between HBV-DNA load and surgical risk. Results: in the high replication group, the anesthetic time, the operation time, the intraoperative bleeding volume were higher than those in the low copy group, and the number of semi-blocking cases was higher than that in the low replication group. But the difference was not statistically significant (P0.05), the hospitalization time was significantly longer than that of the low replication group (P0.05), the alt of the two groups was significantly higher than that of the pre-operation on the 1st day after operation (P0.05), and the level of alt in the high replication group was significantly higher than that in the low replication group (P0.05), and the alt AST level in the two groups decreased 3 days after operation. The decrease of TBIL in the high replication group was significantly higher than that in the low replication group (P0.05). There was no significant change in TBIL level between the two groups on the 1st and 7th day after operation (P0.05), and there was no significant difference between the two groups (P0.05), and the incidence of complications in the low replication group was significantly lower than that in the high replication group (P0.05). The complication Clavien-Dindo grade of low replication group was lower than that of high replication group, the difference was statistically significant (P0.05). Conclusion: the higher the serum HBV-DNA load, the longer the recovery time of liver function, the longer the hospital stay, the higher the incidence of complications and the higher the risk of operation.
【作者單位】： 寧夏醫(yī)科大學(xué)總醫(yī)院感染疾病科;寧夏醫(yī)科大學(xué)總醫(yī)院肝膽外科;
【分類號(hào)】：R735.7

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