| BackgroundHepatocellular carcinoma is a malignant tumor with high mortality,the research confirmed that most of the patients with hepatocellular carcinoma are closely related to the hepatitis b virus.About 90 percent of patients infected with HBV,followed by liver cirrhosis,eventually developed into HCC.Studies have shown that HBV plays an important role in the development of hepatocellular carcinoma and the recurrence of postoperative liver cancer,the serum concentration of HBV-DNA is closely related to the development of liver cirrhosis and liver cancer.Liver cancer resection is still the preferred treatment of liver cancer,but postoperative complications and tumor recurrence has been an important factor in disrupting the prognosis of patients.On the one hand,the patient’s immune capacity is weakening after surgical stress,unable to inhibit the rapid replication of hepatitis B virus,resulting in a large number of hepatitis B virus caused massive damage to liver cells;On the other hand,surgical trauma can also cause the decline of liver function,serious can cause liver failure and even death.Therefore,for patients with hepatocellular carcinoma,not only for early surgical resection,perioperative treatment and prevention of postoperative complications,reduce the rate of recurrence of the tumor should also arouse enough attention.ObjectiveTo study the effect of antiviral therapy on the prognosis of patients with hepatocellular carcinoma after operation,and to analyze the necessity of antiviral treatment to improve the surgical curative effect.MethodRetrospective analysis of the First Affiliated Hospital of Zhengzhou University Hepatobiliary and Pancreatic Surgery in February 2014 February 2016 treatment of 152 patients with hepatocellular carcinoma,according to preoperative HBV-DNA load is different,divided into high viral replication group(serum HBV-DNA load>105 iu/ml)and low viral replication group(103iu/ml<serum HBV-DNA loads <105iu/ml).Each group of patients was divided into formal antiviral and antiviral group according to he standard antiviral treatment.The levels of liver function(ALT,ALB,PA),HBV-DNA level,postoperative complications and tumor recurrence rate were compared between the four groups after radical resection of hepatocellular carcinoma(HCC).Result1、In patients with transaminase,antiviral therapy in patients with A and C than in patients with non-viral treatment of B,D group of patients with low transaminase,A and B,C and D groups of patients with transaminase was statistically significant(P<0.05);In the antiviral treatment group A,C,there was no significant difference in the changes of transaminase between the two groups at the 3rd and 7th day after operation(P﹥0.05),however,the changes of transaminase in the two groups were statistically significant at the 10 th and 14 th day after operation(P<0.05);In the non-antiviral treatment group B,D,the two groups of patients alanine aminotransferase changes were not statistically significant(P﹥0.05).2、In terms of patient albumin,the changes of albumin levels in patients with A and B were statistically significant at 3,7,10 and 14 days after operation(P<0.05);The changes of albumin levels in patients with C and D were statistically significant at 3,7,10 and 14 days after operation(P<0.05);There was no significant difference in albumin level between group A and C,B and D(P﹥0.05).3、In the case of patients with albumin,there was no significant difference in albumin between group A,group B and group C and group D(P>0.05);There were significant differences in albumin between group A and B,C and D at 7,10 and 14 days after operation(P<0.05);In addition,in the antiviral treatment group A,C,there was significant difference between the two groups in PA at 7 days,10 days and 14 days after operation(P<0.05);In the non-antiviral treatment group B,D,there was no significant difference in PA between the two groups(P>0.05).4 、 In patients with serum HBV-DNA levels,antiviral therapy significantly reduced the serum HBV-DNA level of group,the level of serum HBV-DNA in patients without antiviral therapy was slightly higher than that before operation,A and B,C and D in patients with HBV-DNA levels between the two groups was statistically significant(P<0.05);A and C,B and D were not statistically significant in the two groups of patients with HBV-DNA.5、In patients with postoperative complications,A,B,C,D four groups of patients with postoperative complication rate were 13.2%,28.9%,7.9% and 21.1%.The incidence of postoperative complications in patients with antiviral treatment group was obviously lower than that in the patients without antiviral treatment group,and the incidence of postoperative complications between A and B,C and D two groups was statistically significant(P<0.05);A and C,B and D were not statistically significant in the two groups of patients with HBV-DNA(P﹥0.05).6、In patients with liver cancer recurrence rate,A group of 4 cases of patients with recurrence,B group of 9 cases of patients with recurrence(death in 1 case),3 cases of patients with recurrence of group C,group D 7 cases of patients with recurrence.Four groups of patients with liver cancer recurrence rates were 10.5%,23.7%,%,7.9%,18.4%.From the results of antiviral treatment group of patients with liver cancer recurrence rate is lower than without antiviral treatment group of patients with liver cancer recurrence rate,A and B,C and D two groups of patients with liver cancer recurrence rate difference was statistically significant.(P<0.05);A and C,B and D two groups of patients with tumor recurrence rate was not statistically significant(P﹥0.05).Conclusion1、Hepatitis B-related liver cancer patients after the use of entecavir antiviral therapy can reduce serum HBV-DNA levels,improve the patient’s liver function,reduce the incidence of postoperative complications.2、For high viral content of hepatitis B-related liver cancer patients,postoperative antiviral therapy can effectively reduce the recurrence rate of liver cancer and improve the clinical treatment of patients. |
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