腹腔镜与开腹胃楔形切除术治疗胃间质瘤的疗效观察  

Efficacy of laparoscope-assisted open wedge gastric resection for gastric stromal tumors

作　　者：王帅奇[1] 李宗林 罗杰[3] 吕俊[4] WANG Shuai-qi1, LI Zong-lin2, LUO Jie3 , LYU Jun4(1. Gastrointestinal Cancer Cencer, Chongqing Cancer Institute,Chongqing400030, China; 2. Department of Gastrointestinal Surgery, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China; 3. Department of Gastrointestinal Surgery, Panzhihua Central Hospital, Panzhihua 617000, China; 4. Department of Gastrointestinal Surgery, Yibin Second People＇ Hospital, Yibin 644000 chin)

机构地区：[1]重庆市肿瘤研究所胃肠肿瘤中心,重庆400030 [2]西南医科大学附属医院胃肠外科,泸州646000 [3]四川省攀枝花市中心医院胃肠外科,攀枝花617000 [4]宜宾市第二人民医院胃肠外科,宜宾644000

出　　处：《中国肿瘤临床与康复》2018年第3期312-315,共4页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：重庆市科技局计划项目(cstc2017shmsA0767)

摘　　要：目的探讨腹腔镜与开腹胃楔形切除术对胃间质瘤患者的疗效及对前白蛋白(PA)和转铁蛋白(TRF)水平的影响。方法选取2014年2月至2017年2月间重庆市肿瘤研究所收治的56例胃间质瘤患者,根据就诊时间顺序分为观察组与对照组,每组28例。对照组患者采用开腹胃楔形切除术治疗,观察组患者采用腹腔镜胃楔形切除术治疗,对比两组患者各项手术指标水平,术前与术后5d的PA和TRF水平,并发症发生情况及生活质量情况。结果观察组患者术中出血量、切口长度、术后排气时间及住院时间分别为(57.2±12.4)ml、(3.4±1.2)cm、(2.3±1.0)d和(6.9±3.3)d,均显著低于对照组的(130.9±16.9)ml、(15.7±3.2)cm、(4.4±1.2)d和(14.1±5.0)d,差异均有统计学意义(均P<0.05)。观察组患者术后PA及TRF水平分别为(0.15±0.04)ng/L和(1.48±0.32)ng/L,均显著高于对照组的(0.11±0.03)ng/L和(1.22±0.26)ng/L,差异均有统计学意义(均P<0.05)。观察组患者术后并发症发生率为3.6%(1例),显著低于对照组的21.4%(6例),差异有统计学意义(P<0.05)。术后观察组患者各项生活质量评分均显著高于对照组,差异均有统计学意义(均P<0.05)。结论腹腔镜胃楔形切除术治疗胃间质瘤的临床疗效显著,可有效改善患者的PA和TRF水平,有效降低术后并发症,提高生活质量。Objective To study the efficacy of laparoscope-assisted open wedge gastric resection for gastric stromal tumors and the influence on prealbumin（PAE） and transferrin（TRF） levels. Methods Fifty-six patients with gastric stromal tumors who were treated at Chongqing Cancer Institute between February 2014 and February 2017 were selected. According to the adimission sequency,these patients were divided into an observation group and a control group with 28 in each group. The observation group underwent laparoscope-assisted open wedge gastric resection and the control group underwent conventional open wedge gastric resection. The operation indexes,PAE and TRF levels at 5 d before and after operation and complications and quality of surgery were compared between the two groups. Results The intraoperative blood loss,length of incision,postoperative exhaust time and length of hospital stay was（57. 2 ± 12. 4） ml,（3. 4 ± 1. 2） cm,（2. 3 ± 1. 0） d and（6. 9 ± 3. 3） d respectively for the observation group which was significantly lower than（130. 9 ± 16. 9） ml,（15. 7 ± 3. 2） cm,（4. 4 ± 1. 2） d and（14. 1 ± 5. 0） d respectively of the control group（all P〈0. 05）. PAE and TRF levels were（0. 15 ± 0. 04） ng/L and（1. 48 ±0. 32） ng/L respectively for the observation group which were significantly higher than（0. 11 ± 0. 03） ng/L and（1. 22 ± 0. 26） ng/L respectively of the control group after the operation（all P〈0. 05）. The incidence of postoperative complications was 3. 6%（1 patient） for the observation group which was significantly lower than 21. 4%（6 patients） of the control group（P〈0. 05）. The quality of life scores were significantly higher in observation group than in the control group after the operation（all P〈0. 05）. Conclusion Laparoscope-assisted open wedge gastric resection shows high efficacy in the treatment of gastric stromal tumors.It can effectively improve the PAE and TRF levels,reduce the postoperative complications and enha

关 键 词：胃间质肿瘤 腹腔镜 开腹手术 胃楔形切除术 疗效 

分 类 号：R735.2[医药卫生—肿瘤]