腹腔镜联合内镜在胃间质瘤治疗的应用及护理

Application and Nursing of Endo-Laparoscopic Treatment of Gastric Stromal Tumors

目的 探讨腹腔镜联合内镜技术在胃间质瘤治疗中的实用性及有效护理方法.方法 对比分析苏州大学附属第一医院2009年1月—2014年1月开展的35例双镜联合胃间质瘤切除患者与同期开展的49例开腹胃间质瘤切除患者的临床及病理资料,包括患者年龄、肿瘤大小、手术时间、术中出血量、术后进食时间、术后住院天数、并发症、术后病理和随访资料等.结果 双镜组患者在平均年龄、肿瘤直径及手术时间方面对比开腹组,差异无统计学意义（P〉0.05）;而术中出血量、术后进食时间及术后住院天数明显少于开腹组,差异有统计学意义（P〈0.05）.术后随访6~42个月,中位随访17个月,开腹组5例失访,1例术后7个月出现肝转移,1例死亡,双镜组无肿瘤转移、复发及死亡病例.结论 双镜联合治疗胃间质瘤是安全可行的,并具有术中出血少、术后恢复快等优点,要充分做好围手术期的护理.

Objective To explore the effect and suitable nursing methods of endo-laparoscopic cooperation in treatment of gastric stromal tumors （GST）.Methods We analyzed the clinical and pathological characteristics of 35 patients receiving endo-laparoscopic cooperation and 49 patients receiving open resection in The First Affiliated Hospital of Soochow University, such as age, tumor size, operation duration, bleeding, exhaust time, complications, post-operation pathological features and follow-up data.Results Blood loss in the endo-laparoscopic cooperation group （15.6＆#177;8.2） mL was less than the open resection group （85.7＆#177;53.3） mL, exhaust time and length of hospital stay after operation in endo-laparoscopic cooperation group were （1.3＆#177;0.8） d and （2.5＆#177;0.7） d respectively, which were shorter than those （4.9＆#177;2.5） d, （9.3＆#177;5.5） d in open resection group. Follow-up observation was carried out for 6~42 months, medium follow-up time： 17 months. During the period there were 5 cases losing to follow up, 1 case came to hepatic metastasis, 1 came to death in open resection group. Conclusion With less bleeding and shorter recovery phase, endo-laparoscopic cooperation could be a better choice for treating GST. Perioperation nursing should be conducted carefully.