腹腔镜胃癌根治手术对老年病人炎症因子及凝血功能的影响  

Effects of laparoscopic radical gastrectomy on inflammation and coagulation function in the elderly patients

作　　者：周志林[1] 梅勇[1] 戴军[1] 杨旭辉[1] 赵志辉[1] ZHOU Zhi-lin;MEI Yong;DAI Jun;YANG Xu-hui;ZHAO Zhi-hui(Department of General Surgery,Liyuan Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430077,China)

机构地区：[1]华中科技大学同济医学院附属梨园医院普通外科,湖北省武汉市430077

出　　处：《实用老年医学》2019年第5期472-475,共4页Practical Geriatrics

摘　　要：目的探究腹腔镜胃癌根治手术对老年病人炎症因子、凝血指标、白细胞(WBC)、中性粒细胞(NE)及白蛋白(Alb)水平的影响。方法回顾性分析2015年1月至2017年3月我院收治的96例胃癌病人,依据手术方法将病人分为对照组(n=48)和观察组(n=48),对照组行开腹手术,观察组行腹腔镜手术,比较2组手术前1 d,手术后1、3 d时,炎症因子、凝血指标、WBC、NE及Alb水平的变化。结果术后1、3 d,2组白细胞介素-6(IL-6)、IL-8、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、WBC、NE及纤维蛋白原(FIB)水平均较手术前1 d显著增加(P<0. 05),活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)及Alb水平均较手术前1 d显著降低(P<0. 05),且2组比较差异均有统计学意义(P<0. 05)。手术后3 d,2组IL-6、IL-8、TNF-α、CRP、WBC、NE、APTT及PT水平均较术后1 d显著降低(P<0. 05),FIB和Alb水平较术后1 d显著增加(P<0. 05)。结论胃癌根治术可引发机体炎症反应,造成凝血功能异常,相比于开腹手术,腹腔镜胃癌根治术对病人产生的影响较小。Objective To explore the effects of laparoscopic radical gastrectomy on the levels of inflammatory factors, coagulation parameters, white blood cell (WBC), neutrophilicgranulocyte (NE) and albumin (Alb)in the elderly patients.Methods A total of 96 elderly cases of gastric cancer in our hospital from January 2015 to March 2017 were analyzed retrospectively. According to the treatment methods, the patients were divided into the control group ( n = 48) and the observation group ( n = 48). The control group was treated with laparotomy, and the observation group was treated with laparoscopy. The changes of the levels of inflammatory factors, coagulation parameters, WBC, NE and Alb were compared between the two groups 1 d before operation, 1 d, 3 d after operation.Results The levels of interleukin-6(IL-6), IL-8, tumor necrosis factor-α(TNF-α), C reactive protein(CRP), WBC, NE and fibrinogen(FIB) in the two groups were significantly increased,and the levels of activated partial thromboglastin time(APTT),prothrombin time(PT),Alb were significantly decreased 1 d,3 d after operation than those 1 d before operation ( P < 0.05), and there was significant difference between the two groups ( P < 0.05). Compared with those 1 d after operation,the levels of IL-6,IL-8,TNF-α,CRP,WBC,NE,APTT and PT were significantly decreased and the levels of FIB and Alb were significantly increased 3 d after operation in two groups( P < 0.05).Conclusions Radical gastrectomy may lead to inflammatory reaction and coagulation dysfunction.Compare with laparotomy, laparoscopic radical gastrectomy has less adverse effect on patients.

关 键 词：腹腔镜胃癌根治术 炎症因子 凝血指标 白细胞 中性粒细胞 白蛋白 老年人 

分 类 号：R735.2[医药卫生—肿瘤] R656.61[医药卫生—临床医学]