腹腔镜胃癌D2手术的临床疗效观察

Clinical Observation of Laparoscopic D2 Operation for Gastric Cancer

目的观察腹腔镜胃癌D2手术的临床疗效。方法将进行腹腔镜胃癌D2手术的60例患者作为试验组,行传统开腹胃癌根治术30例患者作为对照组。比较2组术前、术后3 d应激反应、炎症及免疫功能,手术与术后指标。结果术后3 d 2组应激指标中SOD指标较术前上升,且试验组高于对照组;而术后3 d 2组应激指标中MDA、炎症下降,且试验组低于对照组;2组免疫功能指标则较术前下降,且对照组低于试验组,差异有统计学意义(P<0.05)。试验组手术时间、术后胃肠道恢复、进流质食、鼻饲肠内营养与住院时间均短于对照组,切口长度少于对照组,且术后发热、止痛剂使用患者及并发症发生率均低于对照组(P<0.05)。结论腹腔镜胃癌D2手术可达到传统手术治疗效果,而相较于传统手术治疗,可减轻对患者所产生的应激反应,降低机体的炎症指标,对免疫功能的影响较小,并可促进术后恢复,减少术后并发症发生,效果理想。

Objective To observe the clinical effect of laparoscopic D2 gastrectomy for gastric cancer.Methods 60 patients with laparoscopic D2 gastrectomy were selected as the experimental group, and 30 patients with traditional open radical gastrectomy were selected as the control group.The stress response, inflammation and immune function before and 3 days after operation were compared between the 2 groups.Results On the 3 rd day after operation, SOD in the 2 groups increased, and the experimental group was higher than the control group;on the 3 rd day after operation, MDA and inflammation in the 2 groups decreased, and the experimental group was lower than the control group;the immune function indexes in the 2 groups decreased, and the control group was lower than the experimental group, and the difference was statistically significant(P<0.05).The operation time, postoperative gastrointestinal recovery, liquid food intake, nasogastric enteral nutrition and hospitalization time of the experimental group were shorter than those of the control group, the incision length was shorter than that of the control group, and the incidence of postoperative fever, analgesic use and complications of the experimental group were lower than those of the control group(P<0.05).Conclusion Laparoscopic D2 gastric cancer surgery can achieve the effect of traditional surgery.Compared with the traditional surgical treatment, it can reduce the stress response of patients, reduce the inflammatory index of the body, has less impact on the immune function, and can promote the postoperative recovery.The effect is ideal.