超声测定皮肤厚度变化判断胃癌D2／D3术后体液转移的价值  

The changes of skin thickness measured by ultrasound evaluate the fluid shift after D2/D3 radical surgery in gastric carcinoma

作　　者：吴文良[1] 全卓勇[1] 邵永胜[1] 张应天[1] 彭开勤[1] 赵建国[1] 

机构地区：[1]江汉大学附属医院胃肠外科,武汉430015

出　　处：《中华实验外科杂志》2010年第4期416-418,共3页Chinese Journal of Experimental Surgery

基　　金：湖北省自然科学基金资助项目（2005ABA127）

摘　　要：目的探讨用超声测定皮肤厚度变化在胃癌D2／D3根治术后液体治疗中的价值。方法28例择期胃癌根治术病例，术后按手术创伤大小分2组，全胃D3术11例，远端胃D2术17例。动态用7．5MHzB超测定前额正中皮肤厚度，并同步用称重床测体质量。比较两组间皮肤厚度增加峰值和体质量增加峰值的差异、皮肤厚度达峰值时间和体质量达峰值时间差异，计算两组皮肤厚度增加值和体质量增加值的相关性。结果两组间皮肤厚度增加峰值[D，组（2．4±0．6）mm，D：组（1．4±0．2）1／mm，t=7．449，P〈0．01]和体质量增加峰值[D3组（5．275±1．230）kg，D2组（2．970±0．497）kg，t=7．768，P〈0．01]的差异有统计学意义；两组皮肤厚度变化和体质量变化均呈正相关（D，组：r=0．99，P〈0．01；D2组：r=0．98，P〈0．01）；皮肤厚度达峰值时间[D3组（26．8±6．1）h，D2组（19．6±5．2）h]均较体质量达峰值时间[现组（27．4±5．4）h，D。组（20．4±4．8）h]提前出现（t=18．856，P〈0．01）。结论胃癌根治术后病例皮肤厚度变化与体质量变化呈正相关，能客观反映术后液体治疗中出现的正平衡和负平衡；皮肤厚度达峰时间较体质量达峰时间提前。超声测定皮肤厚度变化判断胃癌D2／D3根治术后液体平衡具有简单、敏感的优点。Objective To investigate the value of the skin thickness changes measured by ultrasound in the fluid therapy after D2/D3 radical surgery in gastric carcinoma. Methods Twenty-eight patients who had received scheduled radical surgery in gastric carcinoma, were divided into two groups according to the extent of operation： 11 patients subject to total gastrectomy （D3 ）, and 17 patients subject to distal subtotal gastreetomy （ D2 ）. Postoperatively, the change of skin thickness in forehead was monitored by 7. 5 MHz B type ultrasound device every 4 h, and the body weight was measured by using weigh-bed simultaneously. Differences between two groups were studied in the increased peak value of skin thickness and body weight, and the time to their peak values. The correlation of skin thickness and body weight was analyzed. Results Between two groups, there was significant difference in the peak values of skin thickness [D3 group： （2.4±0.6） mm, D2 group： （1.4±0.2） mm,t =7.449,P〈0.01] and body weight [D3 group： （5.275 ±1.230） kg, D2 group： （2.970 ±0.497） kg,t =7.768,P 〈0.01]. There was a positive correlation between skin thickness and body weight within in each group （D3 group：r = 0. 99, P 〈 0. 01 ; D2 group： r = 0. 98,P 〈 0. 01 ）. The time to the peak value of skin thickness [ D3 group： （26. 8 ± 6. 1 ） h, D2 group ： （ 19.6 ± 5.2） h ] was earlier than that of the body weight [ D3 group ： （27.4 ± 5.4） h, D2 group： （20.4±4.8） h] （t =18.856,P〈0.01）. Conclusion The skin thickness showed a strong positive correlation with body weight after scheduled radical surgery in gastric carcinoma, and this can directly reflect the positive and negative balance in postoperative fluid therapy. The time to the peak value of skin thickness was earlier than that of the body weight. The measurement of skin thickness by ultrasound can sensitively and simply evaluate fluid balance after D2/D3 radical surgery in gastric carcinoma.

关 键 词：皮肤厚度 体液转移 超声 胃癌 

分 类 号：R735.2[医药卫生—肿瘤]