腹腔镜胃癌根治术与开腹胃癌根治术的临床疗效比较

Clinical efficacy of laparoscopic and open method in the treatment of gastric cancer radical surgery

目的：比较腹腔镜胃癌根治术与开腹胃癌根治术的临床疗效。方法选取110例行根治性手术治疗的胃癌患者为研究对象，根据不同的手术方式将患者分为观察组和对照组，每组55例。观察组采用腹腔镜手术治疗，对照组采用开腹手术治疗。比较两组手术一般情况，术前1 d、术后1 d、术后7 d、术后10 d 的C-反应蛋白（CRP）水平变化以及术后并发症发生情况。结果对照组手术切口长度、术中失血量、术后排便时间、术后住院时间分别为（24．6±3．7）cm、（99．9±31．8）mL、（5．8±2．7）d、（12．8±7．7）d，观察组分别为（5．6±1．4）cm、（61．3±13．6）mL、（4．5±0．7）d、（9．2±3．9）d，两组差异均有统计学意义（t ＝31．472、5．289、3．194、2．398，均 P ＜0．05）；两组淋巴结清扫个数差异无统计学意义（P ＞0．05）；对照组术前1 d、术后1 d、术后7 d、术后10 d CRP 分别为（18．21±3．67）mg／L、（42．96±7．28）mg／L、（22．88±4．35）mg／L、（15．89±4.34）mg／L，观察组分别为（17．82±3．57）mg／L、（29．97±4．58）mg／L、（16．01±3．16）mg／L、（8．65±1．77）mg／L，术前1 d 两组 CRP 水平差异无统计学意义（P ＞0．05），术后1 d 较术前明显升高，术后7 d、10 d较术后1 d 显著下降，组间比较差异均有统计学意义（t ＝7．497、6．521、8．339，均 P ＜0．05）；观察组并发症发生率为5．45％（3／55），对照组为18．18％（10／55），观察组并发症发生率明显低于对照组，差异有统计学意义（χ2＝6．371，P ＜0．05）。结论相比于传统开腹手术，腹腔镜胃癌根治术创伤小、恢复快、效果好，根治程度与传统手术相当，值得临床推广应用。

Objective To compare the clinical efficacy of laparoscopic and open method in the treatment of gastric cancer radical surgery.Methods 1 1 0 patients who underwent radical surgery for gastric cancer were selected. According to its different operation method,they were divided into observation group and control group,55 cases in each group.The observation group received laparoscopic surgery,and the control group received open operation treat-ment.The general surgery situation,the C -reactive protein （CRP）levels at preoperation and postoperative 1 ,7,1 0d were compared in the two groups.Results The surgical incision length,intraoperative blood loss,postoperative bowel movements and postoperative hospital stay in the observation group were （24.6 ±3.7）cm,（99.9 ±31 .8）mL,（5.8 ± 2.7）d,（1 2.8 ±7.7）d respectively,which were significantly lower than （5.6 ±1 .4）cm,（61 .3 ±1 3.6）mL,（4.5 ± 0.7）d,（9.2 ±3.9）d in the control group（t =31 .472,5.289,3.1 94,2.398,all P 〈0.05）,the number of the lymph node in the two groups had no significant difference（P 〉0.05）.CRP level at 1 d preoperation,1 d postoperation,7d postoperation,1 0d postoperation of the control group were （1 8.21 ±3.67）mg/L,（42.96 ±7.28）mg/L,（22.88 ± 4.35）mg/L,（15.89 ±4.34）mg/L respectively,which of the observation group were （17.82 ±3.57）mg/L,（29.97 ± 4.58）mg/L,（1 6.01 ±3.1 6）mg/L,（8.65 ±1 .77）mg/L respectively,it had no significant difference between the two groups at preoperative 1 d （P 〉0.05 ）,postoperative 1 d both elevated obviously,postoperative 7 d,1 0 d both significantly dropped than postoperative 1 d,and the differences between the two groups were significant （t =7.497, 6.521 ,8.339,all P 〈0.05）.The incidence rate of complications was 5.45%（3 /55）in the observation group,which of the control group was 1 8.1 8%（1 0 /55）,the difference between the two groups was statistically significant（χ2 =6.371 ,P 〈0.05）.Conclusion Compared with the traditional laparotomy,laparoscopic gastric cancer radical has＆nbsp;mild trauma,rapid recovery,the effect is good,quite cure degree,which is worthy of clinical popularization and application.