临床普外科电子杂志 ›› 2023, Vol. 11 ›› Issue (1): 22-.

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洛铂腹腔灌注化疗对原发性肝癌术后患者肝功能及预后的影响研究

  

  1. 广西医科大学附属武鸣医院 肝胆外科,广西 南宁 530199
  • 出版日期:2023-01-01 发布日期:2023-03-07
  • 基金资助:

    广西壮族自治区卫生健康委员会自筹经费科研课题(Z20211311)

Effect of intraperitoneal chemotherapy with lobaplatin on liver function in patients with primary liver cancer after operation

  1. Hepatobiliary Surgery Department of Guangxi Medical University Affiliated Wuming Hospital, Guangxi Nanning 530199, China
  • Online:2023-01-01 Published:2023-03-07

摘要:

目的 探讨洛铂腹腔灌注化疗对原发性肝癌术后患者肝功能及预后的影响。方法 选取2021年7 月至2022 年2 月广西医科大学附属武鸣医院收治的92 例原发性肝癌患者,以随机数字表法分为对照组和观察组,各46 例。对照组给予开腹或腹腔镜肝肿瘤切除术,观察组在对照组的基础上给予洛铂腹腔灌注化疗,术后均随访6 个月。比较两组术前、术后7d、术后1 个月、术后2 个月的血清甲胎蛋

白(alpha-fetoprotein,AFP)及丙氨酸转氨酶(alanine aminotransferase,ALT)、天冬氨酸转氨酶(aspartate transaminase,AST)、总胆红素(total bilirubin,TBIL)水平,并评价两组患者术后6 个月内的预后不良发生情况。结果 术后2 个月,两组患者血清AFP 水平随时间逐渐下降,且术后7d、1 个月、2 个月,观察组血清AFP 水平均低于对照组,差异均有显著性(P < 0.05)。术后2 个月,两组患者血清ALT、AST 水平低于术前,差异有显著性(P < 0.05);但术后7d、1 个月、2 个月两组血清ALT、AST、TBIL 水平比较,差异均无显著性(P > 0.05)。术后6 个月内,观察组预后不良发生率低于对照组,差异有显著性(P < 0.05);而观察组和对照组死亡率分别为0 及2.17%,无显著差异(P > 0.05)。结论 洛铂腹腔灌注化疗并未明显增加原发性肝癌术后患者肝损伤的风险,能改善肝癌患者的预后,临床应用安全,且6 个月内生存情况良好。

关键词: 原发性肝癌, 洛铂, 灌注化疗, 肝功能

Abstract:

Objective To investigate the effect of intraperitoneal chemotherapy with lobaplatin on liver function in patients with primary liver cancer after operation. Method 92 patients with primary liver cancer admitted to our hospital from July 2021 to February 2022 were randomly into the control group (n=46) and the observation group (n=46), the observation group was given intraperitoneal chemotherapy with lobaplatin on the basis of the control group. All patients were followed up for 6 months. The levels of serum alpha-fetoprotein (AFP), alanine aminotransferase (ALT), aspartate transaminase (AST), total bilirubin (TBIL) were compared between the two groups before operation, 7 days after operation, 1 month and 2 months after operation. Result Two months

after operation, the serum AFP level of patients in the two groups gradually decreased with time, and the serum AFP level in the observation group was lower than that in the control group 7 days, 1 month and 2 months after operation (P < 0.05). Two months after operation, the levels of serum ALT and AST in the two groups were significantly lower than those before operation (P < 0.05); However, there was no significant difference in serum ALT, AST and TBIL levels between the two groups at 7d, 1 month and 2 months after operation (P > 0.05). Within 6 months after operation, the incidence of poor prognosis in the observation group was significantly lower than that in the control group (P< 0.05); The mortality rates of the observation group and the control group were 0.00% and 2.17% respectively, with no significant difference (P > 0.05). Conclusion Intraperitoneal chemotherapy with lobaplatin does not significantly increase the risk of liver injury in postoperative patients with primary liver cancer, can improve the prognosis of patients with liver cancer, clinical application of safety, and the survival was good within

6 months.

Key words: Primary liver cancer, Lobaplatin, Perfusion chemotherapy, Liver function