腹腔镜根治术在老年胃癌患者中的应用效果  

Application effect of laparoscopic radical resection in elderly 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] 王文真 GUO Xiaolei;YANG Zhanfeng;FU Yuming;YAN Junhao;WU Wanqing;WANG Wenzhen(Department of Gastrointestinal Thyroid Surgery,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450002,He’nan,China;Department of Digestive Medicine,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450002,He’nan,China)

机构地区：[1]郑州大学第五附属医院胃肠甲状腺外科,郑州450002 [2]郑州大学第五附属医院消化内科,郑州450002

出　　处：《癌症进展》2022年第5期479-482,496,共5页Oncology Progress

摘　　要：目的 探讨腹腔镜根治术在老年胃癌患者中的应用效果。方法 依据治疗方法的不同将106例老年胃癌患者分为观察组和对照组,每组53例,对照组患者实施传统开腹根治术,观察组患者实施腹腔镜根治术。比较两组患者的手术相关指标、炎性因子[C反应蛋白(CRP)和肿瘤坏死因子-α(TNF-α)]水平、免疫因子(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平、血清肿瘤标志物[糖类抗原19-9(CA19-9)、神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)、甲胎蛋白(AFP)]水平、满意度及并发症发生率。结果 观察组患者的术中出血量明显少于对照组,术后肛门首次排气时间、住院时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。治疗后,两组患者的CRP和TNF-α水平均高于本组治疗前,观察组患者CRP和TNF-α水平均低于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者的CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均低于本组治疗前,CD8^(+)水平均高于本组治疗前,且观察组患者的CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于对照组,CD8^(+)水平低于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者的血清CA19-9、NSE、CEA及AFP水平均低于本组治疗前,且观察组患者的血清CA19-9、NSE、CEA及AFP水平均低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的满意度为96.23%,明显高于对照组患者的79.25%(P﹤0.01);观察组患者的并发症总发生率为9.43%,低于对照组患者的24.53%(P﹤0.05)。结论 采用腹腔镜根治术治疗老年胃癌患者可有效改善手术相关指标,降低创伤性刺激诱发的炎性反应,改善免疫抑制状态,降低血清肿瘤标志物水平和并发症发生率,提高患者满意度。Objective To explore the application effect of laparoscopic radical resection in elderly patients with gastric cancer. Method A total of 106 elderly patients with gastric cancer were divided into observation group and control group according to different treatment methods, with 53 cases in each group. The control group was treated with traditional open radical resection, while the observation group was treated with laparoscopic radical resection. The surgical indicators, inflammatory factor [C-reactive protein(CRP) and tumor necrosis factor-α(TNF-α)] levels, immune function levels(CD3^(+), CD4^(+), CD8^(+)and CD4^(+)/CD8^(+)), serum tumor marker [carbohydrate antigen 19-9(CA19-9), neuron specific enolase(NSE), carcinoembryonic antigen(CEA), alpha fetoprotein(AFP)] levels, and satisfaction and complication rate were compared between the two groups. Result The intraoperative blood loss in the observation group was less than that in the control group, the first postoperative anal exhaust time and hospital stay in the observation group were shorter than those in the control group, the differences were statistically significant(P<0.01). After treatment, the levels of CRP and TNF-α in the two groups were higher than those before treatment, and the levels of CRP and TNF-α in the observation group were lower than those in the control group(P<0.05). After treatment, the CD3^(+), CD4^(+)levels and CD4^(+)/CD8^(+)in the two groups were lower than those before treatment, the CD8^(+)levels were higher than those before treatment, the CD3^(+),CD4^(+)levels and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group, and the CD8^(+)level was lower than that in the control group(P<0.05). After treatment, the levels of serum CA19-9, NSE, CEA and AFP in the two groups were lower than those before treatment, and the levels of serum CA19-9, NSE, CEA and AFP in the observation group were lower than those in the control group(P<0.05). The satisfaction rate of the observation group was96.23%, higher than

关 键 词：腹腔镜根治术 胃癌 炎性因子 免疫因子 血清肿瘤标志物 

分 类 号：R735.2[医药卫生—肿瘤]