腹腔镜下胃楔形切除术对胃间质瘤患者预后及免疫功能的影响

Influence of laparoscopic gastric wedge resection on the prognosis and immune function of patients with gastric stromal tumor

目的探讨腹腔镜下胃楔形切除术对胃间质瘤患者预后及免疫功能的影响。方法选取82例胃间质瘤患者,按照随机平行对照法分为两组,对照组41例行开腹胃楔形切除术,观察组41例行腹腔镜下胃楔形切除术。观察并比较两组患者的围术期相关指标、预后指标及免疫功能指标。结果观察组患者术中出血量、创面直径较对照组小,收缩压较对照组低(均P<0.05)。治疗后,两组患者清蛋白、高密度脂蛋白胆固醇(HDL-C)水平较治疗前显著升高,纤维蛋白原-清蛋白比值指数(FARI)值、纤维蛋白原水平较治疗前下降;且观察组上述指标变化幅度较对照组更显著(均P<0.05)。治疗后,两组患者CD4^(+)/CD8^(+)、CD3^(+)T细胞、CD4^(+)T细胞水平均较治疗前升高,且观察组上述指标水平较对照组高(均P<0.05)。结论腹腔镜下胃楔形切除术治疗胃间质瘤患者效果显著,其创口小、出血量少,患者痛苦少、肠道功能恢复快,能够缩短患者禁食时间,从而增加机体免疫力,利于患者预后。

Objective To investigate the influence of laparoscopic gastric wedge resection on the prognosis and immune function of patients with gastric stromal tumors.Methods A total of 82 patients with gastric stromal tumor were selected and assigned to two groups according to the randomized parallel control method,41 patients in the control group received open gastric wedge resection,while 41 patients in the observation group received laparoscopic gastric wedge resection.Perioperative related indexes,prognostic indexes and immune function indexes were observed and compared between the two groups.Results The observation group yielded a less intraoperative blood loss and smaller wound diameter,and lower systolic blood pressure as compared with the control group(all P<0.05).After treatment,the levels of albumin and high density lipoprotein cholesterol(HDL-C)of both groups increased,the values of fibrinogen to albumin ratio index(FARI),and the fibrinogen levels decreased compared with before treatment,and the observation group yielded more significant changes in the indicators as above as compared with the control group(all P<0.05).After treatment,both groups obtained significantly higher levels of CD4^(+)/CD8^(+)、CD3^(+)T and CD4^(+)T cells to compare with before treatment,and the indicators mentioned above in the observation group were higher than those in the control group(all P<0.05).Conclusion Laparoscopic gastric wedge resection has a significant effect on gastric stromal tumors,which has a small wound,less bleeding,less pain and rapid recovery of intestinal function.It can shorten the fasting time in patients,increase the immunity of body,and facilitate the prognosis of patients.