单孔腹腔镜与传统多孔腹腔镜胃癌根治术在早期胃癌患者治疗中的对比分析  

Comparison of single-incision and conventional multi-incision laparoscopic radical gastrectomy in treatment of early gastric cancer

作　　者：杨言通[1] 智鹏柯 周博[1] 陈晔[1] YANG Yantong;ZHI Pengke;ZHOU Bo;CHEN Ye(Department of Gastrointestinal Neoplasms Surgery,The First Affiliated Hospital of Henan University of Sience and Technology,Kaifeng,Henan 475000,China)

机构地区：[1]河南科技大学第一附属医院胃肠肿瘤外科,河南开封475000

出　　处：《淮海医药》2022年第3期221-225,共5页Journal of Huaihai Medicine

基　　金：河南省医学科技攻关计划项目(2018020282)。

摘　　要：目的:对比单孔腹腔镜与传统多孔腹腔镜胃癌根治术在早期胃癌患者治疗中的临床疗效及安全性。方法:选取某院收治的早期胃癌患者95例,采用随机数字表法分为观察组(n=48,单孔腹腔镜胃癌根治术)和对照组(n=47,传统多孔腹腔镜胃癌根治术),比较2组患者手术相关指标、免疫功能(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、凝血功能[凝血酶原时间(PT)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)]、应激反应指标[内皮素-1(ET-1)、CRP、IL-6]、QLQ-C30总分及并发症情况。结果:观察组手术时间为(3.45±0.36)h,长于对照组的(2.89±0.31)h,切口长度为(4.75±0.48)cm,小于对照组的(8.54±0.86)cm,观察组术中出血量(97.66±10.12)mL、肛门排气时间(2.94±0.34)d、引流管留置时间(4.76±0.48)d、住院时间(6.54±0.68)d,均分别短于对照组的(128.75±13.46)mL、(3.16±0.35)d、(5.67±0.59)d、(7.16±0.75)d(P<0.05);术后1周2组患者CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)均下降,但观察组CD4^(+)、CD4^(+)/CD8^(+)高于对照组(P<0.05);术后1周观察组PT、FIB、APTT及ET-1与对照组比较差异无统计学意义(P>0.05);术后6个月观察组QLQ-C30总分、角色功能、情绪功能、社会功能评分均高于对照组(P<0.05),躯体功能、认知功能评分与对照组比较差异无统计学意义(P>0.05);术后6个月内2组均无吻合口瘘、胰腺炎、胰瘘等并发症,且未出现院内死亡病例。结论:与传统多孔腹腔镜胃癌根治术相比,单孔腹腔镜胃癌根治术治疗早期胃癌具有创伤小、术后恢复快、对免疫功能影响小、生活质量高等优势,值得在临床推广实践。Objective:To compare the clinical efficiency and safety of single-incision and conventional multi-incision laparoscopic radical gastrectomy in treatment of early gastric cancer.Methods:95 patients with early gastric cancer hospitalized in a hospital were selected and were randomly divided into an observation group(n=48,single-incision laparoscopic radical gastrectomy)and a control group(n=47,conventional multi-incision laparoscopic radical gastrectomy).The two groups were compared in terms of operation related indexes,immune function(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),coagulation function(PT,FIB,APTT),indexes of stress reaction(ET-1,CRP,IL-6),total scores of QLQ-C30,and complications.Results:The operation time of the observation group was(3.45±0.36)h,longer than the control group's(2.89±0.31)h;the length of incision was(4.75±0.48)cm,smaller than the control group's(8.54±0.86)cm;the bleeding volume(97.66±10.12)mL,the anal exhaust time,(2.94±0.34)d,the indwelling time of drainage tube(4.76±0.48)d,and the hospitalized time(6.54±0.68)d were less or shorter than the control group's(128.75±13.46)mL,(3.16±0.35)d,(5.67±0.59)d,and(7.16±0.75)d respectively(P<0.05).One week after the operation,CD4^(+),CD8^(+),and CD4^(+)/CD8^(+) of the two groups decreased,but CD4^(+) and CD4^(+)/CD8^(+) of the observation group were higher than those of the control group(P<0.05).One week after the operation,there was no statistical difference between the two groups in terms of PT,FIB,APTT and ET-1(P>0.05).6 weeks after the operation,total scores of QLQ-C30,scores of role function,emotional function,and social function of the observation group were all higher than those of the control group(P<0.05),while no statistical difference existed between the two groups in scores of somatic function and cognitive function(P>0.05).Within 6 months after the operation,no complications such as anastomotic fistula,pancreatitis,pancreatic fistula or hospital mortality occurred in the two groups.Conclusion:In comparison with the conventional multi

关 键 词：胃肿瘤 腹腔镜检查 根治术 

分 类 号：R57[医药卫生—消化系统] R735.2[医药卫生—内科学]