胃癌腹腔镜手术与开腹手术近期疗效及机体应激性反应比较  

Comparison of the Short-term Efficacy and Stress Reactions in Patients with Gastric CancerTreated by Laparoscopic Surgery and Open Surgery

作　　者：王静东[1] 张涛[1] 阿地里[1] 杨钦清[1] 王琦三[2] 

机构地区：[1]武警新疆总队医院普外科,新疆乌鲁木齐830001 [2]新疆医科大学附属肿瘤医院腹外科,新疆乌鲁木齐830000

出　　处：《医学临床研究》2017年第4期705-706,710,共3页Journal of Clinical Research

摘　　要：【目的】比较胃癌腹腔镜手术与开腹手术近期临床疗效及机体应激反应。【方法】128例行胃癌D。根治术治疗的患者依据手术方式不同，分为腹腔镜组（A组，n=68）和开腹组（B组，n=60），比较两组近期疗效和术前、术后d1、d2机体应激性反应。【结果】A组淋巴结扫清数目（21．36士7．69）枚、近切端距肿瘤距离（4．86±0．94）cm、远切端距肿瘤距离（4．32±0．76）cm，B组分别为（22．36±9．26）枚、（5．08±1．02）cm和（4．51±0．84）ClTI，两组相比较差异无显著性（P〉0．05）；两组血清IL-6、CRP含量术后dl升高（P〈0．05）、术后d5降低（P〈0．05），IL-10术后d，降低（P〈0．05）、术后d5升高（P〈0．05），且A组术后各指标变化幅度明显小于B组（P〈0．05）。【结论】胃癌腹腔镜手术和开腹手术均具有较好治疗效果，但腹腔镜手术更具微创特点，患者术后恢复快，对患者机体应激性反应影响小。[Objective] To compare the short-term efficacy and stress reactions in patients with gastric cancer treated by laparoscopic surgery and open surgery. [MethodslThe data of 128 patients with gastric canc- er treated by D2 radical resection were retrospectively analyzed. They were divided into the laparoscopic group （A, n=68） and the open group （B, n=60） according to different surgical methods. The postoperative com- plications, short-term efficacy and stress reactions before surgery, 1 and 5days after surgery were compared between groups. [Results]The number of dissected lymph nodes was （21.36±7.69）, distance from the near end to tumor margin was （4.86±0.94） cm and the distance from the distal end to tumor margin was （4.32±0.76） cm, while those of the group B were （22.36±9.26） ,（5.08±1.02）cm and （4.51±0.84）cm, respectively, the two groups showed no significant differences （ P ~0.05）. One day after surgery, serum IL-6 and CRP lev- els increased significantly（ P 〈0.05）, and then decreased at d5 post operation（ P 〈0.05）, while IL-10 de- creased at dl after surgery（ P〈0.05）and then increased at ds （ P〈0.05）, and the changes of the group A were significantly lower than those of the group B （ P〈0.05）.[Conclusion] The effects of both laparoscopic surgery and open surgery are good in the treatment of gastric cancer but the former is more minimally invasive and patients can recover fast, and it has little effect on the stress reactions in patients as well.

关 键 词：胃肿瘤/外科学 腹腔镜检查 治疗结果 应激 

分 类 号：R735.2[医药卫生—肿瘤]