胃癌患者不同根治术后感染与创伤应激指标变化分析  

Influence of radical resections on incidence of postoperative infections and traumatic stress indexes of gastric cancer patients

作　　者：闫永芳[1] 冯新献[1] 徐志霞[1] 张良玉[1] 陈璟[1] 

机构地区：[1]郑州市第一人民医院普外科,河南郑州450004

出　　处：《中华医院感染学杂志》2016年第17期4017-4019,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技厅基金资助项目(20134098760XX)

摘　　要：目的研究腹腔镜与开腹胃癌根治术对胃癌患者感染率和创伤应激指标的临床影响,为胃癌的临床诊治提供参考依据。方法选取2012年12月-2013年12月医院收治的胃癌患者84例,根据不同的手术方法将患者分为研究组和对照组,各42例,研究组给予腹腔镜手术,对照组给予开腹手术,对两组患者术后感染率、手术时间、切口大小、术中出血量、淋巴结清扫数目、血清β内啡肽(β-ep)、肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、住院时间、肛门排气时间、首次流质饮食时间、胃肠减压停止时间等指标进行比较,采用SPSS19.0软件进行统计分析。结果研究组感染率为11.90%,对照组感染率为30.95%,研究组显著高于对照组;研究组患者的手术时间、切口大小、术中出血量水平分别为(127.34±19.34)min、(6.34±1.23)cm、(212.34±48.34)ml,显著低于对照组患者的(188.34±16.34)min、(19.34±2.35)cm、(364.55±66.43)ml;研究组患者β-ep、TNF-α、IL-6分别为(123.44±14.34)pg/ml、(140.32±35.43)pg/ml和(321.23±85.43)pg/ml,显著低于对照组的(159.43±12.03)pg/ml、(166.54±34.09)pg/ml和(408.32±98.43)pg/ml;研究组患者的住院时间、肛门排气时间、首次流质饮食时间、胃肠减压停止时间显著低于对照组,两组比较差异均有统计学意义(P<0.05)。结论与传统开腹手术相比腹腔镜胃癌根治术的感染控制效果更好,患者的创伤应激程度更低,临床恢复效果更佳。OBJECTIVE To explore the clinical effects of laparoscopic radical gastrectomy and laparotomy on infection rate and traumatic stress indexes of gastric cancer patients so as to provide guidance for clinical diagnosis and treatment of gastric cancer.METHODS A total of 84 gastric cancer patients who were treated in the hospital from Dec 2012 to Dec 2015 were enrolled in the study and divided into the study group and the control group,with 42 cases in each according to the surgical procedures,the study group was treated with laparoscopic surgery,and the control group was given the laparotomy.The indicators,including the incidence of postoperative infections,operation duration,sizes of incision,intraoperative blood loss,number of dissected lymph nodes,serumβ-endorphin（β-ep）,tumor necrosis factorα（TNF-α）,interleukin-6（IL-6）,length of hospital stay,flatus time,time of fist liquid diet,and stopping time of gastrointestinal decompression,were observed and compared between the two groups of patients,and the statistical analysis was performed with the use of SPSS19.0software.RESULTS The infection rate of the study group was 11.90%,significantly lower tan 30.95% of the control group.The operation duration of the study group was（127.34±19.34）min,significantly shorter than（188.34±16.34）min of the control group;the size of incision of the study group was（6.34±1.23）cm,significantly shorter than（19.34±2.35）cm of the control group;the intraoperative blood loss volume of the study group was（212.34±48.34）ml,significantly less than（364.55±66.43）ml of the control group.The level ofβ-ep of the study group was（123.44±14.34）pg/ml,significantly lower than（159.43±12.03）pg/ml of the control group;the level of TNF-αof the study group was（140.32±35.43）pg/ml,significantly lower than（166.54±34.09）pg/ml of the control group;the level of IL-6of the study group was（321.23±85.43）pg/ml,significantly lower than（408.32±98.43）pg/ml of the control group.The length of hospital

关 键 词：腹腔镜 胃癌根治术 感染 创伤应激指标 

分 类 号：R656.61[医药卫生—外科学]