腹腔镜下胃癌根治术与开腹胃癌根治术治疗早期胃癌的疗效及对营养水平的影响

Clinical Effect of Laparoscopy and Open Surgery for Early Gastric Cancer and Nutritional Status

目的探讨腹腔镜胃癌根治术与开腹胃癌根治术对早期胃癌患者围术期相关临床指标、血清学指标、术后并发症及营养水平的影响.方法选取30例早期胃癌患者,根据手术方式将其分为试验组(腹腔镜)和对照组(开腹),每组15例.比较两组患者围术期相关临床指标、血清学指标及并发症情况.结果试验组手术时间、术中失血量、切口长度、初次进食时间等均低于对照组(P<0.05),淋巴结清扫数目两组比较差异无统计学意义(P>0.05);术后1 d,两组患者白细胞介素-6(IL-6)水平高于术前(P<0.05),CEA、CA19-9水平低于术前(P<0.05),且试验组低于对照组(P<0.05);试验组并发症总发生率低于对照组(P<0.05);营养水平指标提升试验组高于对照组(P<0.05).结论腹腔镜胃癌根治术具有明显的微创优势,且能减轻患者机体术后炎症反应,术后恢复快,并发症少,营养水平改善明显,值得临床推广应用.

Objective To explore the effects of open surgery and laparoscopic radical gastrectomy on perioperative clinical and serological parameters and postoperative complications and nutritional status in patients with early gastric cancer.Method 30 patients with early gastric cancer were selected as the study subjects,they were divided into control group(laparotomy)and observation group(laparoscopy)according to the different surgical Method s,15 patients for each group.Compare the clinical indicators,serological indicators and complications of patients in the two groups during the perioperative period.Results Operation time,intraoperative blood loss,incisive length,initial eating time in observation group were lower than those in control group(P<0.05).There was no difference in the number of lymph node dissection between the two groups(P>0.05).One day after surgery,the levels of interleukin-6(IL-6)of patients in both groups were significantly higher than before surgery(P<0.05).The levels of CEA and CA19-9 were significantly lower than before surgery(P<0.05),and the observation group was lower than that in control group(P<0.05).The total incidence of complications in the observation group was lower than that in the control group(P<0.05).The nutritional level indicators of the experimental group were higher than those of the control group(P<0.05).Conclusion Laparoscopic radical resection of gastric cancer can demonstrate significant minimally invasive advantages,and can alleviate postoperative inflammatory reactions in patients with rapid postoperative recovery and fewer complications,significant improvement in nutritional status,which is worthy of clinical application.