全腹腔镜远端胃癌根治术的临床效果及对应激反应的影响研究  

The clinical effect of total laparoscopic radical gastrectomy for distal gastric cancer and its influence on stress response

作　　者：李涛 姜丙建 李雪剑 LI Tao;JIANG Bingjian;LI Xuejian(The Second Ward of General Surgery,Hebi People's Hospital,Hebi,Henan 458030,China)

机构地区：[1]鹤壁市人民医院普外科二病区,河南鹤壁458030

出　　处：《社区医学杂志》2024年第24期832-837,共6页Journal Of Community Medicine

摘　　要：目的探讨全腹腔镜远端胃癌根治术的临床效果及对应激反应的影响,为胃癌消化道重建患者良好预后提供有效的科学依据。方法选2020-09-01-2022-09-01鹤壁市人民医院收治的81例接受胃癌消化道重建患者作为研究对象,按照随机数字表法分为2组,传统组40例接受腹腔镜辅助远端胃癌根治术,全腔镜组41例接受全腔镜远端胃癌根治术,观察2组患者各项手术指标、血清炎症因子水平、生活质量及住院期间并发症的发生情况,采用计数资料用%表示,采用χ^(2)检验;计量资料用X±S表示,采用t检验。结果2组术中出血量比较,全腔镜组为(71.12±10.02)m L,传统组为(72.55±10.01)m L,差异无统计学意义,t=0.642,P=0.522;切口长度比较,全腔镜组(3.72±1.05)cm短于传统组(6.75±1.12)cm,差异有统计学意义,t=12.962,P<0.001;手术时间比较,全腔镜组(123.41±12.53)min短于传统组(140.14±14.01)min,差异有统计学意义,t=5.661,P<0.001;首次排气时间比较,全腔镜组(18.81±2.21)h短于传统组(24.15±2.31)h,差异有统计学意义,t=10.626,P<0.001;引流管拔除时间,全腔镜组(6.78±1.02)d短于传统组(7.35±1.03)d,差异有统计学意义,t=2.502,P=0.014;住院时间比较,全腔镜组(12.38±1.07)d短于传统组(15.47±2.06)d,差异有统计学意义,t=8.441,P<0.001;术后3d超敏C反应蛋白(hs-CRP)比较,全腔镜组(8.69±1.36)mg/L少于传统组(9.56±1.52)mg/L,差异有统计学意义,F=5.346,P<0.001;白细胞介素-6(IL-6)比较,全腔镜组(11.56±2.98)pg/m L少于传统组(13.98±4.82)pg/m L,差异有统计学意义,F=8.542,P<0.001;白细胞计数(WBC)比较,全腔镜组(6.16±1.01)10^(9)ml^(-1)少于传统组(7.85±2.04)10^(9)ml^(-1),差异有统计学意义,F=6.788,P<0.001;肿瘤坏死因子-α(TNF-α)比较,全腔镜组(30.01±1.11)pg/m L少于传统组(34.36±1.19)pg/m L,差异有统计学意义,F=9.567,P<0.001;健康状况量表(SF-36)中生理功能比较,全腔镜组(62.25±3.64)分高于传统组(56.78±3.06)分,差异有�Objective To explore the clinical effect of total laparoscopic radical gastrectomy for distal gastric cancer and its influence on stress response,and to provide effective scientific basis for good prognosis of gastric cancer patients with digestive tract reconstruction.Methods A total of 81 patients receiving gastric cancer digestive tract reconstruction admitted to the People's Hospital of Hebi City from 2020 to 09.01 to 2022 to 09.01 were selected as the study objects and divided into 2 groups according to random number table method.40 patients in the traditional group received laparoscopeassisted radical gastrectomy for distal gastric cancer,and 41 patients in the total endoscopy group received radical gastrectomy for distal gastric cancer.Surgical indicators,serum inflammatory factors,quality of life and complications during hospitalization was observed in the 2 groups.Statistical data were represented by%andχ^(2)test was used.The measurement data were expressed as X±S and t test was used.P<0.05 meant that the difference was statistically significant.Results Intraoperative blood loss between the two groups was(71.12±10.02)ml in the endoscopic group and(72.55±10.01)ml in the traditional group,with no statistical significance(t=0.642,P=0.522).The incision length in the endoscopic group was(3.72±1.05)cm shorter than that in the traditional group(6.75±1.12)cm,with statistical significance(t=12.962,P<0.001).The operation time in the endoscopic group was(123.41±12.53)min shorter than that in the traditional group(140.14±14.01)min,the difference was statistically significant,t=5.661,P<0.001;Compared with the first exhaust time,the total endoscope group(18.81±2.21)h was shorter than the traditional group(24.15±2.31)h,and the difference was statistically significant,t=10.626,P<0.001;The drainage tube removal time was(6.78±1.02)d in the endoscopic group than(7.35±1.03)d in the traditional group,and the difference was statistically significant,t=2.502,P=0.014;The length of hospital stay in the total endoscop

关 键 词：全腔镜远端胃癌根治术 胃癌消化道重建 应激反应 手术时间 

分 类 号：R735.2[医药卫生—肿瘤]