腹腔镜远端胃癌根治术中非离断Roux-en-Y吻合治疗胃癌的临床疗效及其对血清肿瘤因子水平的临床疗效  

Clinical efficacy of non-dissocialive Roux-en-Y anastomosis in the treatment of gastric cancer by laparoscopic radical resection of distal gastric cancer and its influence on serum tumor factor levels

作　　者：万玉峰 宋扬 WAN Yufeng;SONG Yang(Department of General Surgery,Jiamusi Central Hospital,Jiamusi,Heilongjiang 154002,China;Department of Proctology,Jiamusi Central Hospital,Jiamusi,Heilongjiang 154002,China)

机构地区：[1]黑龙江省佳木斯市中心医院普外一科,黑龙江佳木斯154002 [2]黑龙江省佳木斯市中心医院肛肠科,黑龙江佳木斯154002

出　　处：《检验医学与临床》2024年第20期3084-3088,共5页Laboratory Medicine and Clinic

摘　　要：目的探讨腹腔镜远端胃癌根治术中非离断Roux-en-Y吻合治疗胃癌的临床疗效及其对血清肿瘤因子水平的影响。方法选取2020年1月至2023年3月该院收治的120例胃癌患者作为研究对象,采用随机数字表法分为治疗A组和治疗B组,每组60例。治疗A组进行腹腔镜远端胃癌根治术Bill-rothⅡ+Braun吻合治疗,治疗B组进行腹腔镜远端胃癌根治术非离断Roux-en-Y吻合治疗。观察并比较两组干预后的术中及术后情况、并发症发生情况、术后1年胃镜检查情况、术后生活质量、血清肿瘤标志物[癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)及糖类抗原125(CA125)]及炎症因子水平[白细胞介素6(IL-6)、C-反应蛋白(CRP)水平及白细胞计数(WBC)]。结果两组手术时长、术中出血量、术后排气时长、胃管留置时长、进流食时长、引流管留置时长、术后住院时长比较,差异均无统计学意义(P>0.05)。两组术后总健康状况、功能领域、症状领域生活质量评分比较,差异均无统计学意义(P>0.05)。干预后治疗A组出现食物潴留18例,残胃炎17例,胆汁反流1例,总发生率为60.00%(36/60);治疗B组出现食物潴留5例,残胃炎4例,胆汁反流0例,总发生率为15.00%(9/60)。两组术后1年胃镜检查情况比较,差异有统计学意义(χ^(2)=25.92,P<0.05)。两组术后CEA、CYFRA21-1及CA125水平均低于术前,且治疗B组CEA、CYFRA21-1及CA125水平均低于治疗A组,差异均有统计学意义(P<0.05)。两组术后IL-6、CRP水平及WBC均高于术前,且治疗B组IL-6、CRP水平及WBC均低于治疗A组,差异均有统计学意义(P<0.05)。两组纳入患者在治疗后均无严重不良并发症。治疗A组出现腹腔感染1例,腹腔出血2例,吻合口狭窄1例,十二指肠残端漏3例,其不良并发症的总发生率为11.67%(7/60);治疗B组出现腹腔感染3例,腹腔出血0例,吻合口狭窄1例,十二指肠残端漏1例,其不良并发症的总发生率为8.33%(5/60)。两组并�Objective To investigate the clinical efficacy of non-dissocialive Roux-en-Y anastomosis in laparoscopic distal gastrectomy for gastric cancer and its effect on serum tumor factor levels.Methods A total of 120 patients with gastric cancer admitted to the hospital from January 2020 to March 2023 were selected as the research objects,and they were divided into treatment group A and treatment group B by random number table method,with 60 cases in each group.Patients in treatment group A were treated with Bill-rothⅡ+Braun anastomosis after laparoscopic distal gastrectomy,while patients in treatment group B were treated with non-dissocialive Roux-en-Y anastomosis after laparoscopic distal gastrectomy.The intraoperative and postoperative conditions,complications,gastroscopy one year after surgery,postoperative quality of life,serum tumor markers[carcinoembryonic antigen(CEA),cytokeratin fragment 19(CYFRA21-1)and carbohydrate antigen 125(CA125)]were observed and compared between the two groups after intervention and inflammatory factors[interleukin-6(IL-6),C-reactive protein(CRP)and white blood cell count(WBC)]levels.Results There was no significant difference in the operation time,intraoperative blood loss,postoperative exhaust time duration of gastric tube retention,liquid food intake time duration of drainage tube retention,and postoperative hospital stay time between the two groups(P>0.05).There was no significant difference in the quality of life scores of general health status,functional field and symptom field between the two groups(P>0.05).After intervention,there were 18 cases of food retention,17 cases of residual gastritis,and 1 case of bile reflux in treatment group A,with a total incidence of 60.00%(36/60).In treatment group B,there were 5 cases of food retention,4 cases of residual gastritis,and 0 case of bile reflux,with a total incidence of 15.00%(9/60).There was statistically significant difference in gastroscopy between the two groups one year after operation(χ^(2)=25.92,P<0.05).The levels of CEA,CY

关 键 词：腹腔镜远端胃癌根治术 非离断Roux-en-Y吻合 胃癌 血清肿瘤因子 癌胚抗原 

分 类 号：R735.2[医药卫生—肿瘤] R446.1[医药卫生—临床医学]