腹腔镜胃癌根治术和开腹手术对胃癌患者胃肠激素水平的影响

To investigate the effect of laparoscopic radical gastrectomy and laparotomy on gastrointestinal hormones in patients with gastric cancer

目的探讨腹腔镜和开腹胃癌根治术对胃癌患者胃肠激素水平的影响。方法回顾性选择2014年5月至2016年10月行胃癌根治术的患者100例,按照手术方法分为对照组和观察组,每组50例,分别施行传统的开腹手术和腹腔镜胃癌根治术。比较两组患者手术前后各种胃肠激素的变化、手术时间、手术出血量等围手术期数据,以及淋巴结清扫数量、术后并发症与手术后的转归情况。结果手术后,对照组患者的胃动素、生长抑素水平降低,血管活性肠肽水平增高,差异均具有统计学意义(P<0.05);观察组患者的各项胃肠激素指标数据与手术前相比均未出现明显变化,差异均无具有统计学意义(P>0.05);两组患者的淋巴结清扫数量比较,差异无具有统计学意义(P>0.05);观察组患者的手术出血量、切口长度、手术后首次排气时间、肠鸣音恢复时间、住院时间比较低于对照组患者,手术时间高于对照组患者,差异均具有统计学意义(P<0.05);两组患者的各类术后并发症数据差异均无具有统计学意义(P>0.05);观察组患者病死率低于对照组患者,差异具有统计学意义(P<0.05)。结论与开腹胃癌根治术相比,腹腔镜胃癌根治术可以降低各种胃肠激素在手术后的变化幅度,缩短患者胃肠道的恢复时间,提高患者的生存率和生存质量,值得临床推广应用。

Objective To investigate the effect of laparoscopic radical gastrectomy and laparotomy on gastrointestinal hormones in patients with gastric cancer. Methods 100 cases of patients undergoing radical gastrectomy from May 2014 to October 2016 were selected. According to random number method,they were divided into control group and observation group,each group of 50 cases,which were respectively performed traditional laparoscopic surgery and laparoscopic radical gastrectomy. The changes of gastrointestinal hormones,operative time,operative bleeding and other perioperative data,postoperative complications and postoperative outcome in two groups were compared. Results After operation,the motilin and somatostatin data in the control group decreased,and the vasoactive intestinal peptide data increased. The data difference was statistically significant（ P 〈 0. 05）. The data of gastrointestinal hormones in the observation group did not change significantly compared with that before operation,and the data difference was not statistically significant（ P 〈 0. 05）. The difference of the number of lymph node dissection in the two groups was not statistically significant（ P 〈 0. 05）. The surgical bleeding volume,incision length,postoperative exhaust time for the first time,borborygmus recovery time,hospitalization time data of observation group patients were lower than those of the patients in the control group,operation time data was higher than the patients in the observation group,the data differences were statistically significant（ P 〈 0. 05）. There was no statistical difference of postoperative complications between the two groups（ P 〈 0. 05）. The mortality rate of the observation group was lower than that of the control group,and the difference of data was statistically significant（ P 〈 0. 05）. Conclusion Laparoscopic radical gastrectomy can reduce the variety of gastrointestinal hormones after operation,shorten the recovery time of gastrointestinal tract,improve the survival rate and quality of life of patients,which is worth popularizing in clinical practice.