腹腔镜下胃癌根治术对胃癌患者临床应激指标及术后并发症的影响  

Influence of laparoscopic radical gastrectomy on clinical stress parameters and postoperative complications in patients with gastric cancer

作　　者：李可可 霍磊 徐继宗[1] 龚江波[1] 宋文军 LI Ke-ke;HUO Lei;XU Ji-zong;GONG Jiang-bo;SONG Wen-jun(Department of General Surgery,Sanxia University Laparoscope Research Institute,Second People’s Hospital of Yichang City,Yichang Hubei 443000,China)

机构地区：[1]宜昌市第二人民医院普外科三峡大学腔镜诊疗研究所,湖北宜昌443000

出　　处：《局解手术学杂志》2019年第1期25-28,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：三峡大学研究生科研创新基金(SDYC2016095)

摘　　要：目的探讨腹腔镜手术对胃癌患者临床应激指标及术后并发症的影响。方法将2015年1月至2017年1月在我院普外科手术治疗的96例胃癌患者按照手术方式不同分为腹腔镜组和开腹组,各48例;对比2组患者手术时间、出血量、清扫淋巴结数目、术后住院时间、肛门排气时间、术后6个月并发症情况;应用酶联免疫吸附法(ELISA)检测并比较术前及术后1 d外周血白细胞(WBC)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的水平。结果腹腔镜组患者的出血量、住院时间、术后肛门排气时间均优于开腹组,手术时间长于开腹组、清扫淋巴结数目少于开腹组,2组比较差异有极显著性统计学意义(P<0.01);术后1 d腹腔镜组患者的WBC、CRP、TNF-α、IL-6低于开腹组,差异有统计学意义(P<0.05);腹腔镜组术后6个月并发症发生率为22.8%,低于开腹组的54.7%,2组比较差异有统计学意义(P<0.05)。结论与传统开腹手术相比,腹腔镜下胃癌根治术在减少住院时间及术中失血量的同时,还能降低应激反应、减少术后并发症发生率。Objective To investigate the effect of the laparotomy and laparoscopic surgery on the stress parameters and complication of patients with gastric cancer.Methods A total of 96 patients diagnosed as gastric cancer and treated by surgery in our hospital from January 2015 to January 2017 were divided into open operation group and laparoscopy group according to the operation method,48 cases in each group.Compared the operation time,bleeding volume,dissected lymph node number,postoperative hospitalization duration and anus exhausting time and complications in 6 months after surgery.The levels of WBC,CRP,TNF-α,IL-6 in serum before and after operation were detected by enzyme-linked immuno sorbent assay and compared.Results Compared with the open operation group,the bleeding volume,postoperative hospitalization duration and anus exhausting time of laparoscopy group were better with less dissected lymph node number and longer operation time,the differences were extremely significant(P<0.01);the WBC,CRP,TNF-α,IL-6 levels of laparoscopy group at 1 day after the operation were lower than those of open operation group(P<0.05).The incidence of complication of laparoscopy group was 22.8%,which was less than 54.7%of control group,the difference was significant(P<0.05).Conclusion Compared with the traditional open operation,laparoscopic radical gastrectomy can shorten the hospital stays and reduce the intraoperative blood loss,the stress response and complication rate after operation.

关 键 词：开腹手术 腹腔镜 胃癌根治术 应激 炎症因子 并发症 

分 类 号：R735.2[医药卫生—肿瘤] R656.6[医药卫生—临床医学]