腹腔镜全胃切除术在胃癌患者中的应用效果  

Application Effect of Laparoscopic Total Gastrectomy in Patients with Gastric Cancer

作　　者：郭晓磊[1] 杨战锋[1] 傅聿铭[1] 闫军浩 吴万庆[1] GUO Xiaolei;YANG Zhanfeng;FU Yuming;YAN Junhao;WU Wanqing(Gastrointestinal and Thyroid Surgery,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第五附属医院胃肠甲状腺外科,河南郑州450000

出　　处：《河南医学研究》2022年第2期278-281,共4页Henan Medical Research

摘　　要：目的观察腹腔镜全胃切除术在胃癌患者中的应用效果。方法选择2018年3月至2020年3月郑州大学第五附属医院治疗的108例胃癌患者,以随机数表法分为研究组和对照组,每组54例。对照组接受开腹全胃切除术治疗,研究组接受腹腔镜全胃切除术治疗。比较两组皮质醇(Cor)、促肾上腺皮质激素(ACTH)、肾上腺素(E)、6-酮前列腺素E1α(6-keto-PGE1α)、血浆P物质(SP)、β-内啡肽(β-EP)、糖类抗原(CA)19-9、CA50、癌胚抗原(CEA)水平,记录两组患者术中出血量、住院时间、胃肠恢复时间,比较两组并发症发生情况。结果术前,两组各指标水平相比,差异无统计学意义(P>0.05)。术后3 d,研究组患者E、Cor、ACTH、SP、6-keto-PGE1α、CEA、CA19-9、CA50水平低于对照组(P<0.05),β-EP水平高于对照组(P<0.05)。研究组术中出血量少于对照组(P<0.05),住院和胃肠功能恢复时间短于对照组(P<0.05)。研究组患者并发症发生率(3.70%)较对照组(18.52%)低(P<0.05)。结论采用腹腔镜全胃切除术治疗胃癌患者,可有效减轻应激反应及疼痛,降低肿瘤标志物水平,减少并发症的发生,有助于患者康复。Objective To observe the application effect of laparoscopic total gastrectomy in patients with gastric cancer.Methods A total of 108 patients with gastric cancer who were treated in the Fifth Affiliated Hospital of Zhengzhou University from March 2018 to March 2020 were selected and divided into study group and control group by random number table method,with 54 cases in each group.The control group received open total gastrectomy,and the study group received laparoscopic total gastrectomy.Cortisol(Cor),adrenocorticotropic hormone(ACTH),epinephrine(E),6-keto prostaglandin E1α(6-keto-PGE1α),plasma substance P(SP),β-endorphin(β-EP),carbohydrate antigen(CA)19-9,CA50,carcinoembryonic antigen(CEA)levels were compared between the two groups.The intraoperative blood loss,hospital stay,and gastrointestinal recovery time were recorded in the two groups.The incidence of complications between the two groups was compared.Results Before surgery,there was no statistical difference in the levels of each index between the two groups(P>0.05).Three days after operation,the levels of E,Cor,ACTH,SP,6-keto-PGE1α,CEA,CA19-9 and CA50 in the study group were lower than those in the control group(P<0.05),and the levels ofβ-EP were higher than those in the control group(P<0.05).The intraoperative blood loss in the study group was less than that in the control group(P<0.05),and the hospitalization and gastrointestinal function recovery time were shorter than those in the control group(P<0.05).The incidence of complications in the study group(3.70%)was lower than that in the control group(18.52%,P<0.05).Conclusion Laparoscopic total gastrectomy in the treatment of gastric cancer patients could effectively reduce stress response and pain,reduce the level of tumor markers,reduce the occurrence of complications,and help patients recover.

关 键 词：胃癌 腹腔镜全胃切除术 应激反应 疼痛介质 糖类抗原 癌胚抗原 并发症 

分 类 号：R735.2[医药卫生—肿瘤]