对比研究腹腔镜与开腹胃癌根治术治疗早期胃癌的临床效果差异性

Comparative Study on Clinical Effect Difference Between Laparoscopic andOpen Radical Gastrectomy in Treatment of Early Gastric Cancer

目的 研究腹腔镜与开腹胃癌根治术治疗早期胃癌的临床效果。方法 选取2019年3月-2020年3月本院收治的早期胃癌患者84例,随机分成对照组和观察组,每组42例。对照组采用开腹胃癌根治术治疗,观察组采用腹腔镜胃癌根治术治疗。比较两组的治疗效果、术中情况、术后恢复情况、术后并发症、手术前后免疫功能水平、术后1年复发率。结果 观察组治疗总有效率为95.24%,高于对照组的71.43%,有显著差异(P<0.05)。观察组切口长度(6.51±2.20)cm、手术时间(218.50±22.61)min、术中出血量(183.80±27.01)mL,分别低于对照组的(15.52±2.73)cm、(271.62±29.52)min、(237.54±32.64)mL,均有显著差异(P<0.05)。观察组术后排气时间(1.61±0.40)d、术后进食时间(4.40±0.81)d、术后住院时间(8.03±0.24)d,分别短于对照组的(3.49±0.95)d、(6.99±0.69)d、(12.70±0.97)d,均有显著差异(P<0.05)。观察组术后并发症发生率为4.76%,低于对照组的23.81%,有显著差异(P<0.05)。两组术前免疫细胞水平相比,无显著差异(P>0.05);术后观察组CRP(15.57±4.16)mg/L、CA72-4(9.10±2.00)U/mL,分别低于对照组的(21.89±2.51)mg/L、(15.92±3.63)U/mL,均有显著差异(P<0.05)。观察组术后1年复发率为2.38%(1/42),低于对照组的19.05%(8/42),有显著差异(P<0.05)。结论 在早期胃癌的临床治疗中,采用腹腔镜胃癌根治术的方法,能够提高治疗总有效率,减轻术中损伤,加快术后恢复速度,同时可减少术后并发症,改善免疫细胞水平,降低复发率,临床效果十分理想。

Objective To study clinical effect of laparoscopic and open radical gastrectomy for early gastric cancer.Methods The paper chose 84 patients with early gastric cancer from March 2019 to March 2020,and divided them into control group and observation group randomly,with 42 cases in each group.Control group was treated with open radical gastrectomy,while observation group with laparoscopic radical gastrectomy.Curative effect,intraoperative condition,postoperative recovery,postoperative complications,immune function level before and after operation,and 1-year recurrence rate was compared between two groups.Results Total effective rate of treatment in observation group was 95.24%,higher than 71.43%in control group,with significant difference(P<0.05).Incision length(6.51±2.20)cm,operation time(218.50±22.61)min,and intraoperative bleeding(183.80±27.01)mL in observation group was lower than control group(15.52±2.73)cm,(271.62±29.52)min,and(237.54±32.64)mL respectively,with statistical significance.(P<0.05).Exhaust time(1.61±0.40)days,postoperative eating time(4.40±0.81)days and length of stay(8.03±0.24)days in observation group was shorter than control group(3.49±0.95)days,(6.99±0.69)days and(12.70±0.97)days respectively,with statistical significance(P<0.05).Incidence of postoperative complications in observation group was 4.76%,lower than control group(23.81%,P<0.05),with statistical significance.There was no significant difference in level of immune cells between two groups before operation(P>0.05).After operation,CRP(15.57±4.16)mg/L and CA72-4(9.10±2.00)U/mL in observation group was significantly lower than control group(21.89±2.51)mg/L and(15.92±3.63)U/mL,respectively,with statistical significance(P<0.05).1-year recurrence rate in observation group was 2.38%(1/42),lower than 19.05%(8/42)in control group(P<0.05),with statistical significance.Conclusion During clinical treatment of early gastric cancer,laparoscopic radical gastrectomy can improve total effective rate of treatment,reduce intraoperative injuries,speed up postoperative recovery,reduce postoperative complications,improve level of immune cells,and reduce recurrence rate,which has ideal clinical effect.