腹腔镜与开腹手术行胃癌根治术的临床效果比较  

Clinical effect comparison of laparoscopic and open radical gastrectomy for gastric cancer

作　　者：李前[1] 陈泽群 苏周生 王卫卫 LI Qian;CHEN Ze-qun;SU Zhou-sheng;WANG Wei-wei(Department of Gastroenterology,Maoming People′s Hospital,Guangdong Province,Maomin 525000,China)

机构地区：[1]广东省茂名市人民医院胃肠外科,广东茂名525000

出　　处：《中国当代医药》2020年第23期96-99,共4页China Modern Medicine

基　　金：广东省茂名市科技计划项目(2011030)。

摘　　要：目的探讨腹腔镜与开腹手术胃癌根治术的临床效果。方法选取2012年2月~2019年7月就诊于我院的84例胃癌患者作为研究对象,按照随机数字表法将其分为A组(42例)、B组(42例)。A组患者行腹腔镜胃癌根治术,B组患者行开腹手术胃癌根治术。比较两组患者的围术期相关指标、手术前后免疫功能及并发症发生情况。结果A组患者的术中失血量、镇痛药物使用次数少于B组,切口长度、下床活动时间、术后住院时间短于B组,手术时间长于B组,差异有统计学意义(P<0.05);两组患者的淋巴结清扫数量比较,差异无统计学意义(P>0.05)。A组患者术后3 d CD3+、CD4^+、CD4^+/CD8^+水平分别为(46.38±2.19)%、(29.39±3.24)%、(1.16±0.12),高于B组的(39.40±2.25)%、(22.45±2.41)%、(0.76±0.10),CD8^+水平为(25.39±2.45)%,低于B组的(29.65±2.86)%,差异有统计学意义(P<0.05)。A组患者的并发症总发生率为4.76%,低于B组的21.43%,差异有统计学意义(P<0.05)。结论腹腔镜胃癌根治术与开腹手术治疗效果相当,但前者具有创伤小、疼痛轻、并发症少、恢复快、对免疫功能影响小等优点,值得临床推广。Objective To explore the clinical effect of laparoscopic and open radical gastrectomy for gastric cancer.Methods From February 2012 to July 2019,84 patients with gastric cancer in our hospital were selected as the study objects,and divided into group A(42 cases)and group B(42 cases)according to the random number table method.Laparoscopic gastrectomy was performed in group A and open radical gastrectomy was performed in group B.The perioperative indexes,immune function before and after surgery and incidence of complications were compared between the two groups.Results In group A,the amount of blood loss and the times of using analgesic drugs were less than those in group B,the length of incision,the time of getting out of bed and the time of hospitalization were shorter than those in group B,and the time of operation was longer than that in group B,the differences were statistically significant(P<0.05).There was no significant difference in the number of lymph node dissections between the two groups(P>0.05).The levels of CD3^+,CD4^+,CD4^+/CD8^+in group A at 3 days after surgery were(46.38±2.19)%,(29.39±3.24)%and(1.16±0.12)%,which were higher than those in group B for(39.40±2.25)%,(22.45±2.41)%,(0.76±0.10),CD8+level was(25.39±2.45)%,which was lower than(29.65±2.86)%in group B,the differences were statistically significant(P<0.05).The total incidence rate of complications in group A was 4.76%,which was lower than 21.43%in group B,the difference was statistically significant(P<0.05).Conclusion Laparoscopic gastrectomy has the same therapeutic effect as open surgery,but the former has the advantages of less trauma,less pain,fewer complications,rapid recovery and less impact on immune function,which is worthy of clinical promotion.

关 键 词：胃癌 胃癌根治术 腹腔镜 免疫功能 

分 类 号：R739[医药卫生—肿瘤]