胃癌切除术后标准淋巴结清扫及扩大淋巴结清扫对炎症因子水平及并发症的影响  

Influence of standard lymph node dissection and extended lymph node dissection on inflammatory factors levels and complications after gastric cancer resection

作　　者：宗洋 沈佳 王利锋 顾剑峰[1] 胡琦[1] Zong Yang;Shen Jia;Wang Lifeng;Gu Jianfeng;Hu Qi(General surgery department,the first people’s hospital of Changshu,Shuzhou,Jiangsu,215500,China)

机构地区：[1]常熟市第一人民医院普外科,江苏苏州215500

出　　处：《齐齐哈尔医学院学报》2023年第4期314-317,共4页Journal of Qiqihar Medical University

基　　金：常熟市科技计划(社会发展)项目(CS202120)。

摘　　要：目的探究胃癌切除术后标准淋巴结清扫及扩大淋巴结清扫对胃癌患者术后炎症因子水平及并发症的影响。方法选择2019年11月—2021年6月本院普外科收治的进行胃癌切除术治疗的胃癌患者102例作为研究对象,采用随机数表法分为扩大组和标准组两组,每组各51例。标准组患者术后进行标准淋巴结清扫,扩大组患者术后进行扩大淋巴结清扫。比较两组患者手术相关指标、淋巴结清扫情况及炎症反应、术后并发症、患者预后情况。结果与标准组相比,扩大组患者手术时间明显延长、术中出血量明显增加、淋巴结其清扫数量及阳性淋巴结清扫数量明显增加,差异有统计学意义(P<0.05)。两组患者术前炎症指标C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)比较,差异无统计学意义(P>0.05),两组患者术后标CRP、TNF-α、IL-6较术前有明显升高(P<0.05),扩大组高于标准组(P<0.05);两组患者术后IL-10较术前有所下降(P<0.05),扩大组低于标准组(P<0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。两组患者术后死亡率比较无统计学差异(P>0.05)。扩大组患者的淋巴结转移发生率明显低于标准组,有统计学差异(P<0.05)。结论扩大淋巴结清扫用于胃癌切除术,会扩大炎症反应,加大创伤刺激,但能显著增加淋巴结及阳性淋巴结清扫数量,且并不会增加患者术后并发症发生率,同时能降低患者术后淋巴结转移发生率,在临床有一定的应用价值。Objective To investigate the effect of standard lymph node dissection and extended lymph node dissection on the level of inflammatory factors and complications in patients with gastric cancer after resection.Methods One hundred and two patients with gastric cancer who underwent gastric cancer resection in the general surgery department of Changshu first people's hospital from November 2019 to June 2021 were selected as the study objects.They were randomly divided into standard group and extended group according to random number table method,fifty-one patients in each group.The patients in standard group underwent standard lymph node dissection after surgery,and patients in the enlarged group underwent extended lymph node dissection after surgery.The related operation indexes,lymph node dissection,inflammatory reaction,postoperative complications and patient prognosis were compared between the two groups.Results Compared with the standard group,the patients in the expanded group had significantly longer operation time,significantly increased intraoperative bleeding,and significantly increased the number of lymph nodes and positive lymph nodes(P<0.05).Before operation,there were no significant differences between the two groups in terms of inflammatory indicators C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-10(IL-10)(P>0.05).After operation,the levels of CRP,TNF-αand IL-6 in the two groups were significantly higher than those before operation(P<0.05),and those in the expanded group were significantly higher than the standard group(P<0.05).The level of IL-10 in the two groups after operation was significantly lower than that before operation(P<0.05),the expanded group was significantly lower than the standard group(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).There was no significant difference in postoperative mortality between the two groups(P>0.05).The incidence of lymph node metastasis in

关 键 词：胃癌切除术 标准淋巴结清扫 扩大淋巴结清扫 炎症水平 并发症 

分 类 号：R735.2[医药卫生—肿瘤]