腹腔镜与开腹手术治疗老年胃癌患者效果及CRP、PCT与术后肠道功能的关系研究

Study on the effects of laparoscopy and open surgery in elderly patients with gastric cancer and the relationship between CRP,PCT and postoperative intestinal function

目的探讨腹腔镜与开腹手术治疗老年胃癌患者效果及CRP、PCT与术后肠道功能的关系。方法选取60例老年胃癌患者并且按照随机数字表法分成腹腔镜组与开腹手术组,每组各30例,各组均采取全麻及相关手术治疗,比较两组患者术后康复情况、手术前后血清CRP与PCT变化情况及术后并发症情况。结果腹腔镜组在肠鸣音恢复、初次排气、初次排便、下床活动及住院时间指标上均较开腹手术组短,差异有统计学意义(P <0.05);在术后1 d、3 d两组血清CRP与PCT水平均较术前升高,但开腹手术组升高较腹腔镜组显著(P <0.05),术后5 d各指标对比差异无统计学意义(P> 0.05);腹腔镜组术后并发症总发生率为6.67%,明显低于开腹手术组的26.67%,差异有统计学意义(P <0.05);术后CRP、PCT明显升高者在肠鸣音恢复时间、初次排气时间及初次排便时间上较不明显升高患者长,差异有统计学意义(P <0.05)。结论对老年胃癌患者而言,腹腔镜手术较开腹手术优势明显,术后血清CRP、PCT值越低,胃肠功能恢复越快。

Objective To investigate the effects of laparoscopy and open surgery in elderly patients with gastric cancer and the relationship between CRP,PCT and postoperative intestinal function.Methods 60 cases of elderly patients with gastric cancer were selected and divided into the laparoscopic group and the open surgery group according to the random number table method,with 30 cases in each group.Each group received general anesthesia and related surgical treatment.The postoperative recovery,serum CRP and PCT changes before and after surgery and postoperative complications of the two groups were compared.Results The laparoscopic group was significantly shorter than the open surgery group in terms of bowel sound recovery,primary exhaust,primary defecation,bed movement and hospitalization time(P<0.05).Serum CRP and PCT indexes in the two groups were improved compared with those in the preoperative group on 1 d and 3 d after surgery,but the improvement in the open operation group was significantly higher than that in the laparoscopic group(P<0.05),and there was no significant difference in the comparison of all indexes on 5 d after surgery(P>0.05).The total incidence of postoperative complications in the laparoscopic group was 6.67%,which was significantly lower than that in the open surgery group(P<0.05).Patients with significantly increased CRP and PCT after surgery had significantly longer bowel sounds recovery time,primary exhaust time and primary defecation time than patients with no significant increase(P<0.05).Conclusion For the elderly patients with gastric cancer,laparoscopic surgery has obvious advantages over open surgery,and the lower the serum CRP and PCT,the faster the recovery of gastrointestinal function.