胃癌患者腹腔镜辅助全胃切除手术治疗的有效性及对患者预后的影响

Efficacy of Laparoscopic-assisted Total Gastrectomy in Patients with Gastric Cancer and Its Influence on Prognosis

目的探讨胃癌患者腹腔镜辅助全胃切除手术治疗的有效性及对患者预后的影响。方法选取78例胃癌患者,采用随机数字表法分为两组,每组各39例。对照组实施开腹全胃切除术,观察组实施腹腔镜辅助全胃切除术。比较两组临床治疗效果、应激指标水平[C反应蛋白(CRP)和皮质醇(COR)水平]以及并发症发生情况。结果对照组手术时间为(198.73±27.64)min,观察组手术时间为(205.27±31.26)min,差异无统计学意义(P>0.05);观察组术中出血量(120.58±18.39)ml,少于对照组的(182.63±24.59)ml,术后首次排气时间(3.82±1.45)min,短于对照组的(5.96±2.63)min,观察组术后第3天COR(140.37±19.54)ng/ml、CRP(21.28±5.03)U/l,低于对照组的(182.26±20.69)ng/ml、(24.29±5.24)U/l,并发症发生率(5.12%)低于对照组(25.64%),差异有统计学意义(P<0.05)。结论胃癌患者应用腹腔镜辅助全胃切除手术治疗效果较佳,能最大限度减轻手术应激反应,减少并发症的发生,利于改善患者预后。

Objective To investigate the effectiveness of laparoscopic-assisted total gastrectomy and its influence on the prognosis of patients with gastric cancer.Methods 78 patients with gastric cancer were selected and divided into 2 groups according to random number table method,with 39 cases in each group.The control group performed open total gastrectomy,and the observation group performed laparoscopic assisted total gastrectomy.The clinical outcomes,levels of stress indicators[C-reactive protein(CRP)and cortisol(COR)levels]and the occurrence of complications were compared between the 2 groups.Results The operation time of the control group was(198.73±27.64)min,and that of the observation group was(205.27±31.26)min,the difference was not statistically significant(P>0.05);In the observation group,the intraoperative blood loss was(120.58±18.39)ml,less than(182.63±24.59)ml in the control group,the first postoperative exhaust time was(3.82±1.45)min,shorter than(5.96±2.63)min in the control group,3 d after operation,COR(140.37±19.54)ng/ml and CRP(21.28±5.03)U/l were lower than(182.26±20.69)ng/ml and(24.29±5.24)U/l in the control group.The complication rate(5.12%)was lower than that of the control group(25.64%),the difference was statistically significant(P<0.05).Conclusion Laparoscopic-assisted total gastrectomy has better therapeutic effect in patients with gastric cancer,which can minimize the surgical stress response,reduce the occurrence of complications,and improve the prognosis of patients.