腹腔镜下远端胃大部切除毕Ⅱ式吻合治疗远端胃癌的价值探讨

The value of laparoscopic distal subtotal gastrectomy with Billroth Ⅱ anastomosis in the treatment of distal gastric cancer

目的探究远端胃癌运用腹腔镜下远端胃大部切除毕Ⅱ式吻合治疗的价值。方法研究随机选取2019年6月-2020年5月我院收治172例远端胃癌患者,所有患者接受远端胃大部切除毕Ⅱ式吻合治疗;依据病床号分组,对照组86例接受传统开腹手术治疗,观察组86例接受腹腔镜下手术治疗,对比两种不同术式围术期指标、术后疼痛、并发症及生活质量等。结果统计学显示,观察组手术切口长度、出血量及术后肛门排气时间、住院时间等均低于对照组,差异有统计学意义(P<0.0S);观察组手术操作时间高于对照组,差异有统计学意义(P<0.05)。两组患者术后6h疼痛VAS评分对比,无统计学差异(P>0.05);术后12h、1d、2d观察组疼痛VAS评分低于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率9.30%、对照组术后并发症发生率26.47%;观察组低于对照组,差异有统计学意义(P<0.05)。入院时两组NHP量表各维度评分对比,并无统计学意义(P>0.05);随访3个月观察组NHP量表疼痛、情感反应、社会生活、精力、躯体生活、睡眠等维度评分优于对照组,差异有统计学意义(P<0.05);随访3个月两组NHP量表各维度评分均下降,与入院时评分对比,差异有统计学意义(P<0.05)。结论远端胃癌患者在腹腔镜下开展远端胃大部切除毕Ⅱ式吻合治疗,手术创伤小,术后恢复快,术后疼痛轻微,有助于减少术后并发症,提高术后生活质量等,值得推广。

Objective To explore the value of laparoscopic subtotal gastrectomy combined with type Ⅱ anastomosis in the treatment of distal gastric cancer.Methods 172 patients with distal gastrie cancer were randomly selected from June 2019 to may 2020 in our hospital.All patients received distal subtotal gastrectomy and Bllroth type Ⅱ anastomosis.According to the hospial bed number,86 patients in the control group received traditional open surgery and 86 patients in the observation group received laparoscopic surgery.The perioperative indicators,postoperative pain,complications and quality of life of the two diferent surgical methods were compared.Results Statistics showed that the length of incision.blod loss.postoperative anal exhaust time and hospitalization time in the observation group were lower than those in the control group,the difference was saistically significant(P<0.05);the operation time of the observation group was higher than that of the control group,the diference was satistically significant (P<0.05).There was no signifeant difference in VAS score between the two groups at 6h afer operation(P>0.05);the VAS score of observation group was lower than that of control group at 12h,Id and 2d after operation,and the diference was staistially significant(P<0.05).The incidence of postoperative complications in the observation group was 9.30%,while that in the control group was 26.47%;the difference was stalistically significant(P<0.05).After 3 months of follow-up,the scores of pain,emotional response,social life,energy,physical life and sleep of the observation group were better than those of the control group,the diference was staistically signifcant(P<0.05);afer 3 months of fllow up,the scores of all dimensions of NHP scale in the Iwo groups were decreased,and the difference was statistically significant(P<0.05).Conc lus ion Laparoscopie subtotal gastrectomy combined with typeⅡ anastomosis for distal gastrie cancer can reduce the postoperative complications and improve the quality of life.