胃镜定位联合腹腔镜治疗胃间质瘤的有效性及安全性评估

Efficacy and safety of laparoscopy combined with gastroscopy in treating gastric stromal tumors

目的 研究胃镜定位联合腹腔镜治疗胃间质瘤的有效性及安全性评。方法 将2009年8月-2013年12月,该院收治的胃间质瘤患者90例纳入研究对象,采用数字表法随机分为观察组（胃镜定位联合腹腔镜治疗）和对照组（仅进行腹腔镜手术）,比较两组患者的手术情况、术后恢复情况及应激反应程度。结果 观察组患者的肿瘤定位时间（17.2±2.1）min、手术时间（40.3±6.2）min、术后肛门排气时间（1.3±0.2）d、流质饮食时间（2.5±0.4）d、卧床时间（3.8±0.5）d以及住院总时间（7.9±0.9）d明显短于对照组;术中出血量（36.2±5.2）mL、术后肾上腺素（94.7±10.4）ng/mL、去甲肾上腺素水平（123.3±14.2）ng/mL、HAMA评分（17.3±2.5）、HAMD评分（16.8±2.3）以及中转开腹（2.22%）明显低于对照组（〈0.05）。结论 胃镜定位联合腹腔镜治疗有助于缩短手术时间、减小手术创伤、促进术后恢复并缓解应激反应,是治疗胃间质瘤安全、有效的手术方法。

[ Objective ] To study the efficacy and safety of laparoscopy combined with gastroscopy in treating gastric stromal tumors. [Methods] Gastric stromal tumors patients in our hospital from August 2011 to December 2013 were enrolled and divided into observation group given laparoscopy eombin.ed with gastroseopy treatment and control group only given laparoscopy surgery. Then surgery condition, postoperative recovery, stress reaction degree of two groups were compared. [Results] Observation group tumor positioning time （17.2±2.1）min, operation time （40.3±6.2）min and postoperative anal exhaust time（1.3±0.2）d, liquid diet time（2.5±0.4）d, bed time（3.8±0.5）d, hospitalization time （7.9±0.9）d were significantly shorter than control group; intraoperation bleeding volume （36.2±5.2）ml and postoperative epinephrine（94.7±10.4）ng/mL, norepinephrine levels （123.3±14.2）ng/mL and HAMA score（17.3± 2.5）, HAMD score （16.8±2.3） were lower than control group, conversion to open surgery （2.22%） were significantly lower than control group （P〈0.05）. [Conclusion] Laparoscopy combined with gastroscopy is effective and safe surgery method because it can shorten operation time, reduce operation wound, promote postoperative recovery and relieve stress.