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益生菌对肝硬化患者肝脏恶性肿瘤手术后肝功能的影响。

Effect of probiotics on liver function after surgery resection for malignancy in the liver cirrhotic.

作者信息

Rifatbegovic Zijah, Mesic Deso, Ljuca Farid, Zildzic Muharem, Avdagic Mustafa, Grbic Kemal, Agic Mirha, Hadziefendic Bahrudin

机构信息

Clinic for Surgery, University Clinical Centre Tuzla, Bosnia and Herzegovina.

出版信息

Med Arh. 2010;64(4):208-11.

Abstract

INTRODUCTION

Hepatic resection is the accepted treatment for various liver tumors. Increasing evidence suggests that two factors significantly influence outcome and successfulness of the hepatic resection in patients with HCC in cirrhosis. There are liver function recovery and the degree of inflammation during early postoperative period.

OBJECTIVE

Aim of this study was to determine whether probiotic use influences on liver function recovery, degree of inflammation during early postoperative period, intraoperative risk, type and frequency of intraoperative and postoperative complications, morbidity, intraoperative and early postoperative mortality and a one-year survival rate in patients who have been used probiotic, and underwent the hepatic resection due to HCC in cirrhosis.

PATIENTS AND METHODS

Study was conducted on 120 patients underwent the hepatic resection due to HCC in cirrhosis. This study has been done in University Clinical Centers Tuzla, Maribor and Strasbourg from October 2006 till February 2008. Patients were divided into 2 groups: 1) patients with liver cirrhosis and histologically verified HCC whom underwent liver resection surgery (segmentectomy/ bisegmenctetomy, right and left hemihepatectomy/extended hemihepatectomy) that used preoperatively and postoperatively probiotics (n = 60), 2) a control group of patients with liver cirrhosis and HCC, which did not use preoperative and postoperative probiotics (N = 60). Treatment with probiotics was conducted 3 days preoperatively and postoperatively with 7 day's oral supplementation.

RESULTS

This study have shown next: patients underwent to the hepatic resection due to HCC in cirrhosis who have been used preoperatively and postoperatively probiotic had liver function recovery better and faster, acute immune response better, serum level of tumor markers lower, intraoperative and postoperative complications were less frequent, and morbidity and mortality rates were lower than in those who have not been using probiotic.

CONCLUSION

Probiotic use may make liver function recovery better and increases immune response in early postoperative period and positively influences outcome and successfulness of the hepatic resection in patients with HCC in cirrhosis.

摘要

引言

肝切除术是治疗各种肝脏肿瘤的公认方法。越来越多的证据表明,有两个因素会显著影响肝硬化合并肝癌患者肝切除术的结果和成功率。这两个因素是肝功能恢复情况以及术后早期的炎症程度。

目的

本研究旨在确定使用益生菌是否会影响使用益生菌且因肝硬化合并肝癌接受肝切除术患者的肝功能恢复、术后早期炎症程度、术中风险、术中和术后并发症的类型及发生率、发病率、术中和术后早期死亡率以及一年生存率。

患者与方法

对120例因肝硬化合并肝癌接受肝切除术的患者进行了研究。本研究于2006年10月至2008年2月在图兹拉、马里博尔和斯特拉斯堡的大学临床中心进行。患者分为两组:1)肝硬化且经组织学证实为肝癌并接受肝切除手术(段切除术/双段切除术、左右半肝切除术/扩大半肝切除术)且术前和术后使用益生菌的患者(n = 60),2)肝硬化合并肝癌的对照组患者,其术前和术后未使用益生菌(N = 60)。术前3天和术后进行为期7天的口服补充益生菌治疗。

结果

本研究显示如下:因肝硬化合并肝癌接受肝切除术且术前和术后使用益生菌的患者肝功能恢复更好、更快,急性免疫反应更佳,肿瘤标志物血清水平更低,术中和术后并发症发生率更低,发病率和死亡率低于未使用益生菌的患者。

结论

使用益生菌可能使肝功能恢复更好,增强术后早期的免疫反应,并对肝硬化合并肝癌患者肝切除术的结果和成功率产生积极影响。

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