术中温水浴疗对肝癌切除术疗效的影响
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梁安林, Email: lianganlin@yeah.net

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海南省卫生厅科研资助项目(琼卫2011-6)。


Impact of intraoperative warm water bath on efficacy of liver cancer resection
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    摘要:

    目的:探讨术中加用温水浴疗的安全性和对肝癌(HCC)切除术疗效的影响。 方法:回顾性分析3年间行术中温水浴疗治疗(肝切除术后余肝温水浸浴1 h)35例HCC患者(手术加浴疗组,浴疗组)临床资料,并选取同期同样例数的行单纯肝切除(手术组)和肝切除加介入(手术加介入组,介入组)的HCC患者资料进行比较。 结果:温水浴疗组术后各免疫球蛋白及可溶性白细胞介素2受体(sIL-2R)水平较术前明显升高(均P<0.05),而其他两组无此改变;在复发率与生存率方面,浴疗组与介入组无统计学差异(均P>0.05),但均优于手术组(均P<0.05);在住院费用和患者痛苦方面,介入组较浴疗组与手术组增加;各组间术后并发症发生率无统计学差异(P>0.05)。 结论:肝切除加术中温水浴疗是HCC安全、有效的治疗方法。它能提高患者术后免疫功能,降低术后复发率,延长患者的生存时间。

    Abstract:

    Objective: To investigate the safety of intraoperative warm water bath during liver cancer (HCC) resection and its influence on therapeutic effects. Methods: The clinical data of 35 HCC patients undergoing intraoperative warm water bath (hepatectomy followed by warm water bath of the remaining liver for 1 h) over the past 3 years were reviewed (warm water bath group), which were compared with the data of the selected HCC patients, who underwent liver resection alone (hepatectomy group) or liver resection plus interventional therapy (interventional group) during the same period, with the same number of cases. Results: The levels of immunoglobulin and soluble interleukin 2 receptor (sIL-2R) were significantly elevated in warm water bath group after surgery compared with those before surgery (all P<0.05), while no such changes were noted in the other two groups. As for the postoperative recurrence and survival, there were no significant differences between water bath group and interventional group (both P>0.05), but both of which were better than those in hepatectomy group (all P<0.05). The hospitalization costs and postoperative pain were increased in interventional group compared with water bath group and hepatectomy group. There were no significant differences in incidence of postoperative complications among groups (P>0.05). Conclusion: Liver resection plus intraoperative warm water bath is a safe and effective method for treatment of HCC, which can provide the patients with enhanced postoperative immune function, reduced recurrence and improved quality of life.

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梁安林|李灼日|周开伦|郑进方|张震生|邢贻雷|武金才|孙启刚|陈家诚.术中温水浴疗对肝癌切除术疗效的影响[J].中国普通外科杂志,2013,22(7):857-861.
DOI:10.7659/j. issn.1005-6947.2013.07.008

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  • 收稿日期:2013-01-15
  • 最后修改日期:2013-07-05
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  • 在线发布日期: 2013-07-15