| 摘要: |
| 目的 评估择期肝切除术与肝射频消融术患者围手术期血浆IL-6、IL-10、CRP的水平，探讨2种手术方式围手术期炎症反应程度及其与短期预后的关系。方法 纳入37例肝占位患者为研究对象，其中择期肝切除术19例、肝射频消融术18例。采用ELISA法检测患者术前、术毕及术后不同时间点血浆IL-6、IL-10、CRP水平，通过非参数检验判断治疗前后的动态变化，并比较2种手术方式围手术期炎症因子水平及预后指标。结果 治疗前后肝切除术患者围手术期血浆IL-6、IL-10、CRP水平及肝射频消融术患者IL-6、CRP水平均存在动态变化（均P＜0.05）。肝切除术后24 h及48 h的IL-6，术毕IL-10，术后24、48、72 h CRP水平均显著高于术前（均P＜0.05）；肝射频消融术术毕IL-6水平显著高于术前（P＜0.05），IL-10、CRP水平在手术前后的差异均无统计学意义（均P＞0.05）。与肝切除术患者比较，射频消融术术后48 h CRP水平降低，术后住院时间缩短（均P＜0.05）。结论 肝射频消融术后全身炎症反应程度相对较小，可能有利于患者加速康复。 |
| 关键词: 肝切除术 肝射频消融术 白细胞介素6 白细胞介素10 C反应蛋白 围手术期 |
| DOI：10.16781/j.CN31-2187/R.20220215 |
| 投稿时间：2022-03-14修订日期：2022-11-14 |
| 基金项目:北京市科技计划项目（Z131100006813037），天普研究基金（UF201324）. |
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| Effect of liver radiofrequency ablation versus hepatectomy on perioperative inflammatory reaction |
| TIAN Xue,HAN Qiaoyu,AN Haiyan,FENG Yi* |
(Department of Anesthesiology, Peking University People's Hospital, Beijing 100044, China
*Corresponding author) |
| Abstract: |
| Objective To assess the levels of interleukin (IL)-6, IL-10, and C reactive protein (CRP) in plasma perioperatively in patients undergoing elective hepatectomy and liver radiofrequency ablation, and to explore the extent of perioperative inflammatory responses and their relationship with short-term prognosis. Methods Totally 37 patients with hepatic lesions were enrolled, including 19 patients undergoing elective hepatectomy and 18 undergoing liver radiofrequency ablation. The plasma levels of IL-6, IL-10 and CRP were detected by enzyme-linked immunosorbent assay preoperatively, immediately after surgery, and at various time points postoperatively. The dynamic changes before and after treatment were determined by non-parametric tests. The levels of perioperative inflammatory factors and prognostic indexes were compared between the 2 surgical methods. Results Significant dynamic changes were observed in the perioperative plasma levels of IL-6, IL-10, and CRP in patients undergoing hepatectomy, as well as in the levels of IL-6 and CRP in patients undergoing liver radiofrequency ablation (all P＜0.05). The levels of IL-6 at 24 and 48 h after hepatectomy, IL-10 immediately after surgery, and CRP at 24, 48, and 72 h postoperatively were significantly higher than those before surgery (all P＜0.05). After liver radiofrequency ablation, the level of IL-6 immediately after surgery was significantly higher than that before surgery (P＜0.05), while the levels of IL-10 or CRP before or after surgery were not significantly different (all P＞0.05). Compared with patients undergoing hepatectomy, the CRP level at 48 h after radiofrequency ablation was significantly lower, and the postoperative hospital stay was significantly shorter (both P＜0.05). Conclusion Postoperative systemic inflammatory response is relatively lower after liver radiofrequency ablation, which may accelerate rehabilitation. |
| Key words: hepatectomy liver radiofrequency ablation interleukin-6 interleukin-10 C reactive protein perioperative period |
