腹腔镜辅助胃癌根治术的临床疗效及对血清炎症因子水平和氧化应激指标的影响  

Clinical effect of laparoscope-assisted radical gastrectomy and the influence on inflammation and oxidative stress

作　　者：贺爱军[1] 曹波[1] 李小宝[1] 任羽[1] He Aijun;Cao Bo;Li Xiaobao;Ren Yu(Department of Gastrointestinal Surgery,Affiliated Hospital of Yan’an University,Shaanxi Yan’an 716000,China)

机构地区：[1]延安大学附属医院胃肠外科,陕西延安716000

出　　处：《中国医刊》2023年第4期405-408,共4页Chinese Journal of Medicine

基　　金：陕西省教育厅自然科学研究项目(16JK2031)。

摘　　要：目的探讨腹腔镜辅助胃癌根治术的临床疗效及对血清炎症因子水平和氧化应激指标的影响。方法选取2019年8月至2021年7月在延安大学附属医院行胃癌根治术的患者95例,根据手术方法的不同分为腹腔镜组(采用腹腔镜胃癌根治术治疗,48例)和开腹组(采用开腹胃癌根治术治疗,47例),比较两组患者的手术相关指标、术后3个月的临床疗效、手术前后的血清炎症因子[血红素加氧酶-1(heme oxygenase-1,HO-1)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)]水平和氧化应激指标[总抗氧化能力(total antioxidant capacity,TAC)、活性氧(reactive oxygen species,ROS)、过氧化氢酶(catalase,CAT)、超氧化物歧化酶(superoxide dismutase,SOD)]以及并发症发生情况。结果腹腔镜组患者的手术时间、估计出血量、切口长度、住院时间及排气时间均明显低于开腹组,差异有显著性(P<0.01),两组淋巴结清扫数目差异无显著性(P>0.05)。术后3个月腹腔镜组的客观缓解率(64.58%)明显高于开腹组(36.17%),差异有显著性(P<0.01)。术前两组血清HO-1、TNF-α、IL-6、CRP水平比较差异无显著性(P>0.05);术后1d和3d,两组血清HO-1、TNF-α、IL-6、CRP水平明显高于术前,且开腹组血清HO-1、CRP水平明显高于腹腔镜组,差异均有显著性(P<0.05);术后1d,开腹组血清TNF-α、IL-6水平明显高于腹腔镜组(P<0.05),术后3d,两组血清TNF-α、IL-6水平比较差异无显著性(P>0.05)。术前两组TAC、SOD、CAT、ROS水平比较差异无显著性(P>0.05);术后1d和3d,腹腔镜组TAC、SOD、CAT水平明显高于开腹组,ROS水平明显低于开腹组,差异均有显著性(P<0.05)。腹腔镜组术后并发症发生率明显低于开腹组,差异有显著性(P<0.05)。结论与传统开腹手术相比,腹腔镜胃癌根治术具有较好的临床效果,并能有效减轻炎症反应、降低氧化应激水平,有利于促�Objective To investigate the perioperative changes of heme oxidase-1,inflammatory factors and oxidative stress indicators in patients undergoing laparoscopic-assisted radical gastric cancer surgery.Method Ninety-five patients undergoing radical gastric cancer surgery in our hospital were selected as the research objects.The screening period was from August 2019 to July 2021.They were grouped according to the differences in surgical treatment plans.48 patients underwent laparoscopic radical gastrectomy(laparoscopic surgery group),47 patients underwent open radical gastric cancer surgery.The clinical efficacy,surgery-related clinical indexes and changes in inflammatory indexes and oxidative stress indexes before and after surgery were compared between the two groups.Result The objective remission rate in the observation group(64.58%)was significantly higher than that in the control group(36.17%),and the difference was statistically significant(P<0.01).The operative time,estimated bleeding,incision length,hospital stay and time to exhaustion of patients in the laparoscopic group were significantly less than those in the open group(P<0.01).At 1 d postoperatively,HO-1 levels,TNF-α,IL-6,and CRP were significantly lower in the laparoscopic group than in the open group(P<0.05).At 3 d postoperatively,HO-1 levels and CRP levels in the laparoscopic group were significantly lower than those in the open group(P<0.05).At 1d and 3d postoperatively,TAC,SOD,and CAT levels were higher in the laparoscopic group than in the open group(P<0.05),and ROS levels were lower than in the open group(P<0.05).The total incidence of postoperative complications in laparoscopic group was significantly lower than that in laparotomy group,and the differences were significant(P<0.05).Conclusion The implementation of laparoscopic radical gastrectomy can effectively reduce the patient’s inflammatory response,reduce the patient’s stress response,and promote the patient’s recovery.

关 键 词：腹腔镜 胃癌根治术 应激反应 炎症因子 

分 类 号：R735.2[医药卫生—肿瘤]