腹腔镜辅助近端胃切除双通道吻合术对早期胃癌患者康复情况及营养状态的影响

Effect of Laparoscopic Assisted Pmximal Gastrectomy with Double-Tract Anastomosis on Rehabilitation and Nutritional Status of Patients with Early Gastric Cancer

目的探究腹腔镜辅助近端胃切除双通道吻合术(PGDT)对早期胃癌患者康复情况及营养状态的影响.方法选取2018年4月—2022年3月我院收治的60例早期胃癌患者,采用随机数字表法分为两组,每组30例.对照组行腹腔镜全胃切除Roux-en-Y空肠吻合术,观察组行腹腔镜辅助PGDT.比较两组的手术效果.结果观察组的手术时长、肛门排气、首次进食及住院时间均短于对照组,术中失血量少于对照组,组间差异有统计学意义(P<0.05).术前,两组的胃动素(MTL)、生长抑制素(SS)、血管活性肠肽(VIP)水平比较,组间差异无统计学意义(P>0.05);术后3 d,观察组的MTL、SS水平均低于对照组,VIP水平高于对照组,组间差异有统计学意义(P<0.05).术前,两组的血红蛋白(Hb)、白蛋白(Alb)、总蛋白(TP)水平比较,组间差异无统计学意义(P>0.05);术后3个月,观察组的Hb、Alb、TP水平均高于对照组,组间差异有统计学意义(P<0.05).观察组的并发症发生率为6.67%,低于对照组的33.33%,差异有统计学意义(P<0.05).结论早期胃癌患者接受腹腔镜辅助PGDT治疗的价值较高,可缩短进食及住院时间,调节胃肠激素,改善营养状况,且并发症较少,值得临床推广使用.

Objective To investigate the effects of laparoscopic assisted pmximal gastrectomy with double-tract anastomosis(PGDT)on the rehabilitation and nutritional status of patients with early gastric cancer.Methods 60 patients with early gastric cancer admitted to our hospital from April 2018 to March 2022 were selected and were divided into two groups by random number table method,with 30 cases in each group.The control group underwent laparoscopic total gastrectomy Rouxen-Y jejunostomy,and the observation group underwent laparosopic assisted PGDT.The operative effects of the two groups were compared.Results The operation duration,anal exhaust,first feeding and hospital stay time in the observation group were shorter than those in the control group,and the intraoperative blood loss was less than that in the control group,the differences between the groups were statistically significant(P<0.05).Before surgery,there were no significant differences in the levels of motilin(MTL),somatostatin(SS)and vasoactive intestinal peptide(VIP)between the two groups(P>0.05);3 days after surgery,the MTL and SS levels in the observation group were lower than those in the control group,and the VIP level was higher than that in the control group,and the differences between the groups were statistically significant(P<0.05).Before surgery,there were no significant differences in the levels of hemoglobin(Hb),albumin(Alb)and total protein(TP)between the two groups(P>0.05);3 months after surgery,the levels of Hb,Alb and TP in the observation group were higher than those in the control group,and the differences between the groups were statistically significant(P<0.05).The incidence of complications in the observation group was 6.67%,lower than 33.33%in the control group,and the difference was statistically significant(P<0.05).Conclusion The value of PGDT treatment for early gastric cancer patients is high,which can shorten the feeding and hospitalization time,regulate gastrointestinal hormones,improve nutritional status,and has fewer complications,so it is worthy of clinical promotion and use.