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目的:评估术前抗病毒治疗对术后乙肝病毒再激活以及肝功能的影响。方法:2012年7月至2016年3月将广西医科大学附属肿瘤医院肝胆胰脾外科乙肝病毒DNA阴性的HCC患者分成抗病毒组(66例)及对照组(108例),抗病毒组术前给予恩替卡韦分散片抗病毒治疗,对照组未给予抗病毒治疗。统计分析术后HBV再激活及肝功能指标变化情况。结果:抗病毒组HBV激活率为3%(2/66),对照组为27.8%(30/108)。多因素分析显示小部分肝切术(HR=4.695;95%CI:1.257-17.537,P=0.021)及术前未抗病毒治疗(HR=8.164;95%CI:1.831-36.397,P=0.006)是术后HBV再激活的危险因素。抗病毒组与未抗病毒组,激活组与未激活组术后7天内肝功能指标差异无统计学意义(P>0.05),术后30天比较,ALT及ALB差异有统计学意义(P<0.05)。结论:对于DNA阴性的HCC患者,肝切除术可导致HBV再激活,术前抗病毒治疗能有效降低HBV再激活风险及保护肝功能。
Objective: To evaluate the effect of preoperative antiviral therapy on postoperative hepatitis B virus reactivation and liver function. METHODS: From July 2012 to March 2016, patients with hepatocellular, hepatobiliary and pancreatic spleen, hepatitis B virus DNA-negative HCC in the affiliated hospital of Guangxi Medical University Cancer Hospital were divided into antivirus group (66 cases) and control group (108 cases) Entecavir dispersible tablets were given antiviral treatment and the control group was not given antiviral treatment. Statistical analysis of HBV reactivation and liver function changes. Results: The rate of HBV activation was 3% (2/66) in the antiviral group and 27.8% (30/108) in the control group. In the multivariate analysis, a small fraction of liver resections (HR = 4.695; 95% CI: 1.257-17.537, P = 0.021) and no antiviral therapy before surgery (HR = 8.164; 95% CI: 1.831-36.397, P = 0.006) Postoperative reactivation of HBV risk factors. There was no significant difference in hepatic function indexes between the antivirus group and non-antiviral group within 7 days after operation (P> 0.05), but there was significant difference between ALT and ALB at 30 days after operation (P < 0.05). Conclusions: Hepatectomy can lead to HBV reactivation in DNA-negative HCC patients. Preoperative antiviral therapy can effectively reduce the risk of HBV reactivation and protect liver function.