腹腔镜与开腹胆囊癌根治术治疗早期胆囊癌的临床疗效比较  

Comparison of clinical efficacy of laparoscopic and open radical cholecystectomy in the treatment of early-stage gallbladder cancer

作　　者：郑又侨 王钢[1] 杨彦伟[1] 刘建学[2] ZHENG Youqiao;WANG Gang;YANG Yanwei;LIU Jianxue(Second Department of Hepatobiliary Pancreaticosplenic Surgery,Baoji Central Hospital,Baoji 721008,Shaanxi,China;Department of Ultrasound Medicine,Baoji Central Hospital,Baoji 721008,Shaanxi,China)

机构地区：[1]宝鸡市中心医院肝胆胰脾外二科,陕西宝鸡721008 [2]宝鸡市中心医院超声医学科,陕西宝鸡721008

出　　处：《癌症进展》2023年第23期2588-2590,2594,共4页Oncology Progress

基　　金：陕西省卫生健康科研基金项目(2021D009)。

摘　　要：目的探讨腹腔镜与开腹胆囊癌根治术治疗早期胆囊癌的临床疗效。方法根据手术方式的不同将60例早期胆囊癌患者分为对照组(n=28,开腹胆囊癌根治术)和观察组(n=32,腹腔镜胆囊癌根治术)。比较两组患者的手术相关指标、血清炎症因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)]水平、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)]、并发症发生情况及复发情况。结果观察组患者术中出血量明显少于对照组,术后排气时间、术后下床活动时间及术后住院时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。术后,两组患者血清IL-6、CRP水平均高于本组术前,观察组患者血清IL-6、CRP水平均低于对照组,差异均有统计学意义(P﹤0.05)。术后,两组患者PT、APTT、TT均短于本组术前,观察组患者PT、APTT、TT均短于对照组,差异均有统计学意义(P﹤0.05)。观察组患者并发症总发生率低于对照组(P﹤0.05)。两组患者2年复发率比较,差异无统计学意义(P﹥0.05)。结论腹腔镜胆囊癌根治术治疗早期胆囊癌能够达到与开腹胆囊癌根治术相同的疗效,且可缩短患者住院时间,促进患者术后恢复,减轻炎症反应,改善凝血功能指标,降低术后并发症发生率。Objective To investigate the clinical efficacy of laparoscopic and open radical cholecystectomy in the treatment of early-stage gallbladder cancer.Method A total of 60 patients with early-stage gallbladder cancer were divided into control group(n=28,open radical cholecystectomy)and observation group(n=32,laparoscopic radical cholecystectomy)according to different surgical methods.The surgery-related indicators,serum inflammatory factor[interleukin-6(IL-6),C-reactive protein(CRP)]levels,coagulation function indicators[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT)],complications and recurrence were compared between the two groups.Result The intraoperative blood loss of the observation group was significantly less than that of the control group,the postoperative exhaust time,postoperative get out of bed time,and postoperative hospitalization time were significantly shorter than those of the control group,and the differences were statistically significant(P<0.05).After the surgery,the serum IL-6 and CRP levels of the two groups were higher than those before the surgery,the serum IL-6 and CRP levels in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the surgery,the PT,APTT,and TT of the two groups were shorter than those before the surgery,and the PT,APTT,and TT of the observation group were shorter than those of the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group(P<0.05).There was no statistically significant difference in the 2-year recurrence rate between the two groups(P>0.05).Conclusion Laparoscopic radical cholecystectomy for early-stage gallbladder cancer can achieve comparable efficacy as open radical cholecystectomy,and could shorten the patient's hospitalization time,promote postoperative recovery,reduce inflammatory reactions,improve coagulation function indicators

关 键 词：早期胆囊癌 腹腔镜胆囊癌根治术 炎症因子 凝血功能指标 并发症 

分 类 号：R735.8[医药卫生—肿瘤]