腹腔镜和开腹胃癌根治术治疗胃癌合并慢性阻塞性肺病的临床疗效及安全性评价  

Curative Effect and Safety of Radical Gastrectomy with Laparotomy or Laparoscope for Patients with Gastric Cancer

作　　者：张海斌 

机构地区：[1]陕西省铜川市妇幼保健院,727000

出　　处：《实用癌症杂志》2017年第8期1314-1317,共4页The Practical Journal of Cancer

摘　　要：目的探讨腹腔镜和开腹胃癌根治术治疗胃癌合并慢性阻塞性肺病的临床疗效及安全性评价。方法选取胃癌合并慢性阻塞肺病患者90例,根据患者意愿将其分为两组,每组45例,腹腔镜组患者接受腹腔镜辅助胃癌根治术治疗,开腹组患者接受开腹胃癌根治术。比较两组患者的手术情况和术后并发症的发生情况。结果腔镜组患者的切口长度显著短于开腹组患者(P<0.05);腔镜组患者的手术时间显著长于开腹组(P<0.05),腔镜组患者术中出血量显著少于开腹组(P<0.05),术中淋巴结的清扫数量显著多于开腹组(P<0.05);腔镜组患者术后使用镇痛泵的使用次数显著少于开腹组患者(P<0.05);腔镜组患者术后肛门排气时间和住院时间显著短于开腹组(P<0.05);腔镜组患者术后下床活动时间显著早于开腹组患者(P<0.05)。腔镜组肺部并发症发生率为15.67%,显著低于开腹组为60.00%(P<0.05);腔镜组患者腹部并发症发生率为15.67%,显著低于开腹组的42.22%(P<0.05)。结论腹腔镜辅助胃癌根治术治疗胃癌合并慢性阻塞性肺病的临床疗效显著,有利于患者术后恢复,有效降低患者术后发生腹部和肺部并发症的发生率,值得临床推广应用。Objective To explore the curative effect and safety of radical gastrectomy with laparotomy or laparoscope for patients with gastric cancer. Methods 90 patients with gastric cancer were divided into 2 groups as patients reference, group laparotomy （n = 45 ） accepted radical gastrectomy with laparotomy, and group laparoscope （n = 45 ） adopted same surgery with lap- aroscope, comparing the operative conditions and postoperative complications between the 2 groups. Results The incision lengths of patients in group laparoscope was shorter than group laparotomy significantly（ P 〈 0.05 ） ;The operative blood loss in group lap- aroscope was lower than that group laparotomy （P 〈 0.05 ） ; The time of analgesia pump using in group laparoscopy was significant- ly less than group laparotomy（ P 〈 0.05 ） ; The time of anal exhaust and hospitalization of patients in group laparoscopy was signifi- cantly shorter than group laparotomy（ P 〈 0.05 ） ;The postoperative ambulation time of patients in group laparoscope was signifi- cantly earlier than than group laparotomy（ P 〈 0.05 ） ;The incidence of pulmonary complications in group laparoscopic（ 15.67% ） were significantly lower than group laparotomy（60.00% ） （P 〈 0.05） ;and abdominal complications＇ incidence in group laparo- scopic was 15.67% ,which significantly lower than the laparotomy group 42.22% （P 〈 0.05）. Conclusion The radical gastrec- tomy with laparoscopic for gastric cancer complicated with chronic obstructive pulmonary disease deserved popularization in clin- ic, which curative is remarkable, and improved the postoperative recovery of patients, decreased incidence of abdominal and pul- monary complications.

关 键 词：腹腔镜 胃癌合并慢性阻塞肺病 临床疗效 并发症 

分 类 号：R735.2[医药卫生—肿瘤]