腹腔镜辅助远端胃癌根治术的临床疗效及围术期护理

The clinical efficacy and perioperative nursing in laparoscopy-assisted distal gastric resection

目的探讨腹腔镜辅助远端胃癌根治术的临床疗效及围术期护理。方法选取本院2008年1月～2010年5月收治的远端胃癌患者58例,随机分为两组,将采用开腹手术行远端胃癌根治术及围术期护理的患者为对照组29例,将采用腹腔镜辅助远端胃癌根治术及围术期护理的患者为观察组29例,分别比较两组患者术中和术后各项指标。结果观察组手术时间[(198.4±29.1)min]、术中出血量[(136.5±23.7)mL、下床活动时间[(4.3±0.8)d]、术后肛门排气时间[(2.1±0.7)d]、胃管拔出时间[(3.9±1.1)d]、进食流质时间[(4.4±1.5)d]、平均住院时间[(7.1±0.8)d]、镇痛药物使用比例(31.0%)和并发症发生比例(69.0%)均明显少于对照组[手术时间(247.3±48.6)min、术中出血量(252.8±39.0)mL、下床活动时间(6.1±1.5)d、术后肛门排气时间(3.6±1.0)d、胃管拔出时间(6.4±1.5)d、进食流质时间(5.8±1.3)d、平均住院时间(9.7±2.6)d、镇痛药物使用比例(72.4%)和并发症发生比例(93.1%)],差异均有统计学意义(均P<0.05)。结论腹腔镜辅助远端胃癌根治术的临床疗效显著,同时采取有效的围术期护理可以减轻患者手术的痛苦,减少并发症的发生,且患者术后恢复快,是一种安全的手术治疗方法,值得临床推广使用。

Objective To investigate the clinical efficacy and perioperative nursing in laparoscopy-assisted distal gastric resection.Methods 58 patients in the hospital from January 2008 to May 2010 treated with distal gastric cancer were randomly divided into two groups,the patients of using open surgery distal gastric cancer and perioperative care were chosen as the control group with 29 cases,the patients of using laparoscopic-assisted distal gastric resection and perioperative care of patients were chosen as the observation group with 29 cases,postoperative indicators in two groups of patients were compared.Results The operative time [（198.4 ± 29.1） min],blood loss [（136.5 ± 23.7） mL],ambulation time [（4.3 ± 0.8） d],anal exhaust time [（2.1 ± 0.7） d],pull out the tube time [（3.9 ± 1.1） d],liquid feeding time [（4.4 ± 1.5） d],the average length of stay [（7.1 ± 0.8） d],the ratio of analgesic drug use [（31.0%）] and the ratio of complications [（69.0%）] in observation group were significantly less than that in control group,such as operative time [（247.3 ± 48.6）] min,blood loss [（252.8 ± 39.0）] mL,ambulation time [（6.1 ± 1.5） d],anal exhaust time [（3.6 ± 1.0） d],time to pull out the stomach [（6.4 ± 1.5）] d,liquid feeding time [（5.8 ± 1.3）] d,the average length of stay [（9.7 ± 2.6）] d,the ratio of analgesic drug use（72.4%） and the ratio of complications（93.1%）,the differences were statistically significant（all P 〈 0.05）.Conclusion Laparoscopy-assisted distal gastric resection of clinical effect is significant,while taking effective perioperative care of patients surgery can reduce pain,reduce complications with rapid postoperative recovery of patients,and it is a safe surgical treatment,which is worthy of clinical use