微创根治术治疗进展期胃癌的近远期疗效  

Short-and long-term curative efficacy of minimally invasive radical surgery and its effects on immune function and HIF-1α expression in patients with advanced gastric cancer

作　　者：赵华洲[1] 王婷[2] 安丹[1] 张彩霞[1] 邱啸臣[1] 翁剑锋[1] 曹志宇[1] 何建苗[1] 杨波[1] ZHAO Hua-zhou;WANG Ting;AN Dan;ZHANG Cai-xia;Q_IU Xiao-chen;WENG Jian-feng;CAO Zhi-yu;HE Jian-miao;YANG Bo(Department of General Surgery,309 Hospital of Chinese PLA,Beijing 100091,China;Department of Medical Affairs,Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100020,China)

机构地区：[1]解放军309医院普通外科,北京100091 [2]首都医科大学附属北京朝阳医院医务处,北京100020

出　　处：《解放军医学杂志》2018年第8期694-697,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：目的观察腹腔镜辅助微创根治术治疗进展期胃癌的近远期疗效,以及对免疫功能、缺氧诱导因子-1α(HIF-1α)水平的影响。方法选择2010年2月至2012年3月解放军第309医院普通外科收治的胃癌患者90例为研究对象,其中微创组48例,行腹腔镜辅助微创根治术(简称微创根治术),开腹组42例,行常规开腹手术。对比分析两组患者的近期疗效,包括各项临床指标(术中出血量,进食、排气、手术、住院时间,淋巴结清扫数),术后并发症发生率以及免疫功能指标(C3、C4,Ig G、Ig A、Ig M),血清C反应蛋白(CRP)和HIF-1α水平变化;远期疗效为5年存活率指标。结果两组均成功手术,无围术期死亡。微创组出血量、进食流质时长、排气时间、并发症发生率、术后CRP水平和HIF-1α值均小于开腹组(P<0.05);两组5年存活率比较差异无统计学意义(P>0.05)。结论对于进展期胃癌的治疗,近期疗效微创根治术优于常规开腹手术,但远期疗效在两组间无差异。Objective To observe the short- and long-term efficacy of minimally invasive radical surgery and its effect on immune function and hypoxia inducible factor-1α （HIF-1α） expression in patients with advanced gastric cancer, and provide a reference for clinical treatment of gastric cancer. Methods A total of 90 patients with gastric cancer, admitted from Feb. 2010 to Mar. 2012, were enrolled in present study. Of the 90 patients, 48 underwent minimally invasive radical surgery （laparoscopic assisted radical surgery, laparoscopic group）, and 42 underwent routine laparotomy （laparotomy group）. The short-term efficacy included various clinical indexes （intraoperative bleeding, liquid diet time, exhaust time, operating time, hospital stay, lymph nodes）, the incidence of postoperative complications and the immune function indexes （C3, C4, IgG, IgA, IgM） and the levels of C-reaction protein （CRP） and HIF-1α in serum. The long-term efficacy included five-year survival rate. Results No perioperative death occurred in the two groups with successful operation. The indexes of intraoperative bleeding, liquid diet time, exhaust time, incidence of complications, and the levels of CRP and HIF-1α were better in laparoscopic group than in laparotomy group （P〈0.05）. No significant difference was found in the S-year survival rate between the two groups （P〉0.05）. Conclusion For treatment of advanced gastric cancer, the minimally invasive radical surgery is superior to conventional laparotomy on the recent efficacy, but not on long-term efficacy.

关 键 词：微创根治术 进展期胃癌 缺氧诱导因子1Α 免疫功能 

分 类 号：R605[医药卫生—外科学]