腹腔镜远端胃癌根治术毕Ⅱ式联合Braun吻合术对胃癌肠道屏障功能血清炎性因子水平的影响

Effect of Laparoscopic Cadical Gastrectomy for Distal Gastric Cancer of Billroth Ⅱ Anastomosis Combined with Braun Anastomosis on Intestinal Barrier Function and Serum Inflammatory Factors Levels in Gastric Cancer

目的: 探究腹腔镜远端胃癌根治术毕Ⅱ式联合Braun吻合术对胃癌肠道屏障功能、血清炎性因子水平的影响。 方法: 回顾性分析我院行毕Ⅱ式吻合术(对照组)及行毕Ⅱ式联合Braun吻合术(观察组)的腹腔镜远端胃癌根治术患者各56例临床资料。记录两组围术期指标(手术时间、消化道重建时间、术中出血量、术后排气时间、术后住院时间)及术后并发症发生情况,并比较两组术前及术后3d肠道屏障功能[二胺氧化酶(DAO)、D-乳酸]、炎性因子[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)]、免疫功能(补体C3、C4)差异。 结果: 两组手术时间、消化道重建时间、术中出血量、术后排气时间、术后住院时间比较,差异均无统计学意义(P>0.05)。观察组术后并发症总发生率明显低于对照组(P<0.05)。术后3d时,两组肠道屏障功能(血清DAO、D-乳酸)、炎性因子(血清IL-6、IL-10)均较术前升高(P<0.05),且对照组高于观察组(P<0.05);两组免疫功能(血清补体C3、C4)均较术前降低(P<0.05),且对照组低于观察组(P<0.05)。 结论: 毕Ⅱ式联合Braun吻合术应用于腹腔镜远端胃癌根治术效果显著,能同时改善患者术后肠道屏障功能及炎性水平,并降低手术对免疫功能的影响,于减少术后并发症也有利。

Objective: To explore the effect of laparoscopic radical gastrectomy for distal gastric cancer of Billroth Ⅱanastomosis combined with Braun anastomosis on intestinal barrier function and serum inflammatory factors levels in gastric cancer. Methods: A retrospective analysis was performed on clinical data of each 56 patients who underwent laparoscopic radical gastrectomy for distal gastric cancer of Billroth Ⅱanastomosis (control group) and BillrothⅡanastomosis combined with Braun anastomosis (observation group) in our hospital. Perioperative indicators (operative time, gastrointestinal reconstruction time, intraoperative blood loss, postoperative exhaust time, postoperative hospital stay) and occurrence of postoperative complications were recorded in the two groups, and the intestinal barrier function [diamine oxidase (DAO), D-lactic acid], inflammatory factors [interleukin-6 (IL-6), interleukin-10 (IL-10)] and immune function [complements C3 , C4] were compared between the two groups before operation and at third day after operation. Results: There were no significant differences in the operative time, gastrointestinal reconstruction time, intraoperative blood loss, postoperative exhaust time and postoperative hospital stay between the two groups (P>0.05). The total incidence rate of postoperative complications in observation group was significantly lower than that in control group (P<0.05). At 3d after operation, the intestinal barrier function (serum DAO, D-lactic acid) and inflammatory factors (serum IL-6, IL-10) in the two groups were higher than those before operation (P<0.05), and the indexes in control group were higher than those in observation group (P<0.05). The immune function indexes (serum complements C3, C4) in the two groups were lower than those before operation (P<0.05), and the indexes in control group were lower than those in observation group (P<0.05). Conclusion: Billroth Ⅱanastomosis combined with Braun anastomosis has significant effects in laparoscopic radical gastrectomy for distal gastric cancer. And it can improve the postoperative intestinal barrier function and inflammatory level, and reduce the impact of surgery on immune function so as to help reduce postoperative complications.