| Purpose of researchProspective observe if the hepatitis B related hepatocellular carcinoma patient that lower HBV loads HBV reactivation occurred in perioperative period. What’s relation of the variation of HBV loads and hepatic function in perioperative period. What’s relation of the variation of HBV loads and postoperative complications in perioperative period. Discuss the security and validity that operation unite nucleotide or nucleoside anologues antiviral therapy in perioperative period.Research methodProspectively collected the patient that receive treatment in guangxi medical university affiliated tumor hospital hepatobiliary surgical department in May2013—March2014.patient inclusion criteria:HBsAg(+) and HBV-DNA>the minimum detection limit (5.0×102copies/mL),but not reached the consensus therapy for chronic hepatitis B in the asia-pacific region, the latest edition(2012) of anti HBV treatment demand, preoperative live function classification for Child-Pugh, A/B(liver function score7points or less),are indications of liver tumor resection,postoperative pathology confirmed for HCC patients. A total of88patients match condition. On admission will conform to the set of conditions of patients were randomly divided into A, B two groups (A and B)44patients in both groups, group A patients (treatment group), two days before operation using nucleoside drugs resistant HBV treatment; Group B (control group) patients, preoperative nucleoside drugs resistant HBV treatment is not to be used until the perioperative reactivation of HBV in happening, and according to the patients with HBV-DNA levels and ALT levels, liver cirrhosis, reached the consensus therapy for chronic hepatitis B in the asia-pacific region in the latest edition (2012) anti HBV treatment demand, namely began to give. Observe the change of the two groups HBV-DNA, white blood cells, liver and kidney function, and the postoperative complications and average length of stay indexes and so on in perioperative period.Results1. The treatment group (group A) patients during the application of nucleoside kind of HBV drug therapy, no obvious adverse drug reactions occur, no nucleoside drugs related to white blood cells decline and kidney damage.2. The control group (group B) throughout the postoperative hospital stay of successively appeared in16patients reactivation of HBV-DNA, reactivation rate was36.4%, while at the same time, the treatment group (group A) throughout the postoperative hospital stay no1cases of patients with HBV-DNA reactivation, reactivation rate was0.00%, which shows P=0.000<0.05, there are statistically significant differences.3. The treatment group (group A) compared with control group (group B), faster postoperative recovery of liver function (in preoperative postoperative changes of ALT as representatives), which have statistically significant difference between the two groups, but the total bilirubin, albumin, PT time, etc., while the treatment group showed the trend of heal more quickly than the control group, compared two groups have no statistical differences.4. The treatment group (group A) compared with control group (group B), lower the incidence of postoperative complications, risk for complications is2.5times that of the treatment group, that is statistically significant difference between the two groups5. The treatment group (group A) compared with control group (group B), average length of stay and postoperative average length of stay are shorter, compared the difference was statistically significant.Conclusion1. HBV-DNA low loads of hepatitis B related HCC patients have HBV reactivation risk in perioperative;2. Perioperative combination nucleoside drugs resistant HBV treatment is safe, can prevent HBV reactivation, promote postoperative recovery of liver function, reduce postoperative complications and shorten the average length of stay effectively. In a word, perioperative combination nucleoside drugs resistant HBV treatment can make the patients benefit.
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