腹腔镜下胃癌根治术对患者应激炎症因子影响及肠道屏障功能影响分析

Analysis of the effects of laparoscopic radical gastrectomy for gastric cancer on inflammatory cytokines and intestinal barrier function in patients

目的 探讨腹腔镜胃癌根治术对患者血清应激炎症因子、肠道屏障功能的影响.方法 对我院2014年1月至2016年9月手术治疗的140例胃癌患者临床资料进行回顾性分析,其中66例采用腹腔镜下胃癌根治术（腹腔镜组）、74例采用传统开腹胃癌根治术（传统组）,对比两组患者的围手术期指标、炎症因子及肠道屏障功能指标.结果 腹腔镜组患者的出血量[（86.8±15.2） ml]、切口长度[（6.2±1.4） cm]、首次肛门排气时间[（3.0±0.6） d]、流质饮食时间[（4.6±0.9） d]、术后住院时间[（8.8±1.7） d]均低于传统组 [分别为（158.2±25.0） ml、（16.3±2.7） cm、（3.6±0.7） d、（5.1±0.8） d、（10.3±2.5） d,],两组比较差异均有统计学意义（P值分别为：0.000、0.000、0.000、0.014、0.001）;传统组的手术时间[（196.5±27.8） min]、清扫淋巴结数目[21.6±2.8）个]与腹腔镜组[分别为（192.5±30.3） min、（22.0±3.1）个]比较,差异均无统计学意义（P值分别为：0.421、0.137）;腹腔镜组患者术后24、72 h的WBC、IL-6、CRP、TNF-ɑ、皮质醇、血浆D-乳酸、二胺氧化酶水平均低于传统组（P值均为0.000）.结论 腹腔镜胃癌根治术对患者血清应激炎症因子、肠道屏障功能影响较小.

Objective To study the effects of laparoscopic radical gastrectomy for gastric cancer on serum inflammatory cytokines and intestinal barrier function in patients.Methods Retrospective analysis was used to investigate a total of one hundred and forty gastric cancer patients in Ezhou Central Hospital from January 2014 to September 2016,including 66 cases with laparoscopic radical gastrectomy （laparoscopic group） and 74 cases with traditional open radical gastrectomy （traditional group）,the perioperative indexes,inflammatory factors and intestinal barrier function of the two groups were compared.Results In the laparoscopic group,the amount of bleeding loss in the laparoscopic group （（86.8 ± 15.2） ml）,the incision length （（6.2 ± 1.4） cm）,the first anal exhaust time （（3.0 ± 0.6） d）,the fluid diet time （（4.6 ± 0.9） d）,the postoperative hospitalization （（8.8 ± 1.7） d） were all lower than those in the traditional group （（158.2±25.0） ml,（16.3±2.7） cm,（3.6±0.7） d,（5.1±0.8） d,（10.3±2.5） d）,the differences were statistically significant （P=0.000,0.000,0.000,0.014,0.001）;the operation time of the traditional group was （196.5±27.8） min,the number of lymph nodes was （21.6±2.8）,compared with those in the laparoscopic group （（192.5±30.3） min,（22.0±3.1）,P=0.421,0.137）.The levels of WBC,IL-6,CRP,TNF-ɑ,COR,plasma D-lactic acid and diamine oxidase in the laparoscopic group were lower than those in the traditional group （P=0.000）.Conclusion The effect of laparoscopic radical gastrectomy on serum inflammatory cytokines and intestinal barrier function in patients is not obvious.