腹腔镜辅助与开腹D2胃癌根治术对老年进展期胃癌患者的疗效探讨  

Efficacy of laparoscopic assisted and open D2 radical gastrectomy on advanced gastric cancer in the elderly

作　　者：张智[1] 于朋涛 ZHANG Zhi;YU Peng-tao(Department of Gastrointestinal surgery,Laiyang Central Hospital,Yantai 265200,China)

机构地区：[1]烟台市莱阳中心医院胃肠外科,265200

出　　处：《中国实用医药》2024年第20期6-9,共4页China Practical Medicine

摘　　要：目的探讨腹腔镜辅助与开腹D2胃癌根治术对老年进展期胃癌患者的疗效。方法研究对象为100例老年进展期胃癌患者,按照住院号随机分为对照组(50例,开展开腹D2胃癌根治术治疗)和观察组(50例,开展腹腔镜辅助D2胃癌根治术治疗)。比较两组临床指标[术中出血量、手术时间、住院时间、首次下床活动时间、首次肛门排气时间、视觉模拟评分法(VAS)评分],治疗效果,术后并发症发生情况,炎性指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、干扰素-γ(IFN-γ)、转化生长因子-β(TGF-β)]。结果观察组的术中出血量(215.89±24.20)ml少于对照组的(346.45±26.24)ml,手术时间(212.31±24.45)min、住院时间(10.44±4.23)d、首次下床活动时间(3.09±1.01)d、首次肛门排气时间(2.89±0.80)d短于对照组的(257.81±25.81)min、(14.35±4.23)d、(4.94±1.21)d、(4.25±1.21)d,VAS评分(2.69±0.84)分低于对照组的(4.75±1.22)分,差异化显著(P<0.05)。观察组的治疗总有效率98.00%高于对照组的86.00%,差异化显著(P<0.05)。观察组的术后并发症发生率2.00%低于对照组的16.00%,差异化显著(P<0.05)。治疗后,观察组的TNF-α(133.24±9.33)ng/ml、IL-6(362.48±18.04)pg/ml低于对照组的(171.95±9.22)ng/ml、(409.16±18.42)pg/ml,差异化显著(P<0.05);两组IFN-γ、TGF-β比较差异均衡(P>0.05)。结论老年进展期胃癌患者行腹腔镜辅助D2胃癌根治术治疗,能提升患者的治疗效果及恢复效果,利于并发症的减少,促进患者疾病更快康复,效果显著。Objective To explore the efficacy of laparoscopic assisted and open D2 radical gastrectomy on advanced gastric cancer in the elderly.Methods 100 elderly patients with advanced gastric cancer were selected as study subjects,and divided into a control group(50 patients,open D2 radical gastrectomy)and an observation group(50 patients,laparoscopic assisted D2 radical gastrectomy)according to randomized hospitalization number.Both groups were compared in terms of clinical indicators[intraoperative blood loss,operation time,hospitalization time,first ambulation time,first anal exhaust time,visual analog scale(VAS)score],treatment effect,complications,inflammatory indicators[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interferon-γ(IFN-γ),and transforming growth factor-β(TGF-β)].Results The intraoperative blood loss of(215.89±24.20)ml in the observation group was less than(346.45±26.24)ml in the control group;in the observation group,the operation time was(212.31±24.45)min,the hospitalization time was(10.44±4.23)d,the first ambulation time was(3.09±1.01)d,and the first anal exhaust time was(2.89±0.80)d,which were shorter than(257.81±25.81)min,(14.35±4.23)d,(4.94±1.21)d,and(4.25±1.21)d in the control group;VAS score of(2.69±0.84)points in the observation group was lower than(4.75±1.22)points in the control group;the difference was significant(P<0.05).The total effective rate of 98.00%in the observation group was higher than 86.00%in the control group,and the difference was significant(P<0.05).The incidence of postoperative complications of 2.00%in the observation group was lower than 16.00%in the control group,and the difference was significant(P<0.05).After treatment,the observation group had TNF-αof(133.24±9.33)ng/ml and IL-6 of(362.48±18.04)pg/ml,which were lower than(171.95±9.22)ng/ml and(409.16±18.42)pg/ml in the control group,and the difference was significant(P<0.05).Comparison of IFN-γand TGF-βbetween the two groups was balanced(P>0.05).Conclusion For elderly patients with advanced

关 键 词：腹腔镜 D2胃癌根治术 开腹 老年进展期胃癌 效果 

分 类 号：R735.2[医药卫生—肿瘤]