術(shù)前抗病毒治療對肝癌術(shù)后肝功能恢復(fù)及并發(fā)癥的影響
發(fā)布時間:2018-12-12 15:40
【摘要】:[目的]研究乙肝相關(guān)性肝細(xì)胞癌(HCC)患者,乙肝病毒(HBV)DNA高載量是否會對患者術(shù)后肝功能的恢復(fù)及并發(fā)癥產(chǎn)生影響。[方法]回顧性分析2012年12月至2016年12月間在昆明醫(yī)科大學(xué)第一附屬醫(yī)院肝膽外科行手術(shù)治療的符合納入標(biāo)準(zhǔn)的52例HCC患者,術(shù)前經(jīng)過恩替卡韋0.5mg qd po或阿德福韋酯10mg qd po或拉米夫定0.1g qd po或后兩者聯(lián)合治療1-3周后,HBV-DNA值降至103copies/ml或以下的有31例,將這31例患者定義為抗病毒組(HBV-DNA≤103copies/ml,n=31),21例未經(jīng)過抗病毒治療且術(shù)前查HBV-DNA103copies/ml的患者定義為非抗病毒組(HBV-DNA103copies/ml,n=21),分別統(tǒng)計(jì)兩組患者的年齡、性別、有無肝硬化、AFP值、Child分級、HbeAg陰陽性、手術(shù)方式、切除肝段、手術(shù)時間、有無肝門阻斷、術(shù)中出血、術(shù)中和術(shù)后有無輸血、術(shù)后病理分級、術(shù)前和術(shù)后1天、3天、7天肝功能指標(biāo)、術(shù)前和術(shù)后7天HBV-DNA值、術(shù)后并發(fā)癥,運(yùn)用統(tǒng)計(jì)學(xué)中t檢驗(yàn)、配對t檢驗(yàn),重復(fù)資料方差分析,X2檢驗(yàn)對比分析這兩組患者結(jié)果。[結(jié)果]52例HCC患者均得到有效肝切除,術(shù)前和術(shù)后7天分別查兩組患者HBV-DNA值對比,t檢驗(yàn)結(jié)果非抗病毒組差異均無統(tǒng)計(jì)學(xué)意義(P=0.437),抗病毒組差異亦無統(tǒng)計(jì)學(xué)意義(P=0.918);術(shù)前對兩組患者年齡、性別、有無肝硬化、AFP值、Child分級、HbeAg陰陽性、手術(shù)方式、切除肝段、手術(shù)時間、有無肝門阻斷、術(shù)中出血、術(shù)中和術(shù)后有無輸血、術(shù)后病理分級對比分析,結(jié)果差異均無統(tǒng)計(jì)學(xué)意義(P值均0.05);術(shù)前查兩組患者ALT、AST、PT、TBIL差異也無統(tǒng)計(jì)學(xué)意義(P值分別為0.550、0.747、0.920、0.676),術(shù)后1天、3天、7天復(fù)查與術(shù)前重復(fù)方差分析結(jié)果差異有統(tǒng)計(jì)學(xué)意義(P0.001),抗病毒組患者肝功能恢復(fù)優(yōu)于非抗病毒組;術(shù)后兩組患者單個并發(fā)癥對比分析中,非抗病毒組(HB V-DNA ≤ 103 copies/ml,n=31)與抗病毒組(HB V-DNA103 copies/ml,n=21)患者在難治性腹水(這里定義為經(jīng)過一定時間嚴(yán)格水、鈉控制和充分利尿劑治療后,仍無明顯療效,術(shù)后7天內(nèi)腹水量500ml/天)、切口延遲愈合(這里定義為因腹水、膽瘺、感染這三種因素引起的切口不愈合,拆線時間12天)上差異有統(tǒng)計(jì)學(xué)意義(P值分別為0.034、0.023);在術(shù)后總體并發(fā)癥對比分析中,兩組患者差異也有統(tǒng)計(jì)學(xué)意義(P=0.012)。[結(jié)論]1.本研究中,非抗病毒組HCC患者手術(shù)前與術(shù)后圍手術(shù)期內(nèi)關(guān)于HBV-DNA變化的對比分析,抗病毒組HCC患者手術(shù)前與術(shù)后圍手術(shù)期內(nèi)關(guān)于HBV-DNA變化的對比分析,由于病例數(shù)少,差異均不具有統(tǒng)計(jì)學(xué)意義;2.術(shù)前抗病毒治療(HBV-DNA降至103copies/ml或以下為標(biāo)準(zhǔn))更有助于HCC患者術(shù)后肝功能恢復(fù)和降低術(shù)后并發(fā)癥發(fā)生率。
[Abstract]:[objective] to study whether the high load of hepatitis B virus (HBV) (HBV) DNA in patients with hepatitis B associated hepatocellular carcinoma (HCC) will affect the recovery of liver function and complications after operation. [methods] from December 2012 to December 2016, 52 patients with HCC who were treated by hepatobiliary surgery in the first affiliated Hospital of Kunming Medical University were analyzed retrospectively. After preoperative treatment with entecavir 0.5mg qd po or adefovir 10mg qd po or lamivudine 0.1 g qd po or combined therapy for 1-3 weeks, the HBV-DNA value decreased to 103copies/ml or below in 31 cases. These 31 patients were defined as antiviral group (HBV-DNA 鈮,
本文編號:2374836
[Abstract]:[objective] to study whether the high load of hepatitis B virus (HBV) (HBV) DNA in patients with hepatitis B associated hepatocellular carcinoma (HCC) will affect the recovery of liver function and complications after operation. [methods] from December 2012 to December 2016, 52 patients with HCC who were treated by hepatobiliary surgery in the first affiliated Hospital of Kunming Medical University were analyzed retrospectively. After preoperative treatment with entecavir 0.5mg qd po or adefovir 10mg qd po or lamivudine 0.1 g qd po or combined therapy for 1-3 weeks, the HBV-DNA value decreased to 103copies/ml or below in 31 cases. These 31 patients were defined as antiviral group (HBV-DNA 鈮,
本文編號:2374836
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