不同手术方式对胃肠间质瘤患者胃肠功能及并发症的影响

Effect of different surgical methods on gastrointestinal function and complications in patients with gastrointestinal stromal tumors

目的观察和比较不同手术方式治疗胃肠间质瘤的临床疗效与安全性。方法选取2019年3月至2021年3月信宜市人民医院收治的77例胃肠间质瘤患者为研究对象,按照随机数字表法分为对照组(38例)和试验组(39例)。对照组患者接受开腹手术治疗,试验组患者接受腹腔镜手术治疗。比较两组患者手术成功情况、手术相关指标;比较两组患者的术后疼痛数字评价量表(NRS)评分;比较两组患者的胃功能指标血清胃泌素(GAS)及胃动素(MTL)及并发症发生情况。结果两组患者均顺利完成手术,病理组织学检查证实切缘阴性,肿瘤切除完整,试验组无中转开腹,手术成功率均为100%。试验组患者的术中出血量少于对照组(P<0.05),术后排气、进食时间和术后恢复活动时间均早于对照组(P<0.05);术后住院时间短于对照组(P<0.05)。试验组患者术后3 d NRS评分低于对照组(P<0.05)。两组患者术后血浆GAS升高、MTL降低,但试验组患者的术后血浆GAS低于对照组,血浆MTL高于对照组,差异均有统计学意义(P<0.05)。试验组并发症发生率(5.13%)低于对照组(21.05%),差异有统计学意义(P<0.05)。结论腹腔镜手术与开腹手术均能有效治疗胃肠间质瘤。腹腔镜切除胃肠间质瘤,其创伤相对较小,对胃肠功能干扰小、并发症少,且术后恢复快,临床应用更具优势。

Objective To explore the efficacy and safety of different surgeries for gastrointestinal stromal tumors(GIST).Methods 77 cases of GIST patients admitted in Xinyi People's Hospital from March 2019 to March 2021 were selected as research object and were divided into the experimental group(laparoscopic surgery,39 cases)and the control group(open surgery,38 cases).The surgical success rate,surgery-related indicators,the postoperative Numerical Pain Rating Scale(NRS)score,gastrointestinal function[gastrin(GAS),motilin(MTL)],and complications were compared between the two groups.Results Both groups of patients successfully completed the operation,histopathological examination confirmed negative margins,complete tumor resection,no conversion to open surgery in the experimental group,and the success rate of the operation was 100%.The blood loss during the operation of the experimental group was less than that of the control group(P<0.05),and the postoperative exhaust gas,eating time,and postoperative recovery time were earlier than those of the control group(P<0.05);the postoperative hospital stay was shorter than the control group(P<0.05).Plasma GAS increased and MTL decreased in the two groups of patients after surgery,but the GAS of the test group was lower than that of the control group,and the MTL was higher than that of the control group.The differences were statistically significant(P<0.05).The complication rate of the experimental group(5.13%)was lower than that of the control group(21.05%),and the difference was statistically significant(P<0.05).Conclusion The success rate of laparoscopic surgery and open surgery were effective.Laparoscopic surgery for removal of gastrointestinal stromal tumors had less trauma,less bleeding,less interference with gastrointestinal function,fewer complications,and faster postoperative recovery,which had more advantages in clinical applications.