完全腹腔镜远端胃癌D2根治术对进展期胃癌患者术后恢复及应激反应的影响  

Effect of total laparoscopic D2 radical distal gastrectomy on postoperative recovery and stress response in patients with advanced gastric cancer

作　　者：张军明 张戈 陈劲强 ZHANG Junming;ZHANG Ge;CHEN Jinqiang(Department of General Surgery,Shangrao People's Hospital,Jiangxi Province,Shangrao 334000,China;Department of Obstetrics and Gynecology,Shangrao People's Hospital,Jiangxi Province,Shangrao 334000,China)

机构地区：[1]江西省上饶市人民医院普外科,江西上饶334000 [2]江西省上饶市人民医院妇产科,江西上饶334000

出　　处：《中国当代医药》2024年第32期57-60,65,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202212754)。

摘　　要：目的探讨完全腹腔镜胃癌D2根治术对进展期胃癌患者术后恢复及应激反应的影响。方法回顾性分析2020年1月至2023年1月上饶市人民医院收治的70例进展期胃癌患者的临床资料,按照手术方案将其分为对照组(30例)和观察组(40例),对照组患者采用腹腔镜辅助下远端胃癌D2根治术,观察组患者采用完全腹腔镜远端胃癌D2根治术。比较两组患者的根治效果、术后恢复情况、应激反应指标[丙二醛(MDA)、超氧化物歧化酶(SOD)、一氧化氮(NO)、C反应蛋白(CRP)]、肿瘤监测指标[胃蛋白酶原1(PG1)、胃泌素17(G-17)、低氧诱导因子-1α(HIF-1α)]。结果两组的淋巴结清扫数量、远切端与肿瘤距离、近切端与肿瘤距离比较,差异无统计学意义(P>0.05)。观察组的术后下床时间、排气时间、进食时间、住院时间短于对照组,术后并发症总发生率低于对照组,差异有统计学意义(P<0.05);术后第1天,观察组的MDA水平高于对照组,SOD、NO、CRP水平低于对照组,差异有统计学意义(P<0.05);术后第7天,观察组的PG1水平高于对照组,G-17、HIF-1α水平均低于对照组,差异有统计学意义(P<0.05)。结论完全腹腔镜远端胃癌D2根治术能显著提高进展期胃癌患者的恢复速度,减轻患者炎症应激反应,更好地改善肿瘤指标水平。Objective To investigate the effect of total laparoscopic D2 radical distal gastrectomy on postoperative recovery and stress response in patients with advanced gastric cancer.Methods The clinical data of 70 patients with advanced gastric cancer admitted to Shangrao People's Hospital from January 2020 to January 2023 were retrospectively analyzed.According to the surgical plan,they were divided into control group(30 cases)and observation group(40 cases).The patients in the control group were treated with laparoscopic-assisted D2 radical distal gastrectomy,and the patients in the observation group were treated with total laparoscopic D2 radical distal gastrectomy.The curative effect,postoperative recovery,stress response indexes(malondialdehyde[MDA],superoxide dismutase[SOD],nitric oxide[NO],C-reactive protein[CRP]),tumor monitoring indexes(pepsinogen 1[PG1],gastrin 17[G-17],hypoxia-inducible factor-1α[HIF-1α])were compared between the two groups.Results There were no significant differences in the number of lymph node dissection,the distance between distal resection end and tumor,and the distance between proximal resection end and tumor between the two groups(P>0.05).The time of getting out of bed,exhaust time,eating time and hospitalization time of the observation group were shorter than those of the control group,and the total incidence of postoperative complications was lower than that of the control group,and the differences were statistically significant(P<0.05).On the first day after operation,the MDA level of the observation group was higher than that of the control group,and the SOD,NO and CRP levels were lower than those of the control group,and the differences were statistically significant(P<0.05).On the 7th day after operation,teh PG1 of the observation group was higher than that of the control group,and G-17 and HIF-1αwere lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion The total laparoscopic D2 radical distal gastrectomy can significantly

关 键 词：进展期胃癌 完全腹腔镜远端胃癌D2根治术 腹腔镜辅助下远端胃癌D2根治术 术后恢复 应激反应 

分 类 号：R735.2[医药卫生—肿瘤]