传统开腹术与腹腔镜手术治疗胃癌的临床效果比较

Comparison of Open Laparotomy and Laparoscopic Surgery in the Treatment of Patients with Gastric Cancer

目的比较分析开腹与腹腔镜手术治疗胃癌的临床效果。方法选取66例胃癌患者作为研究对象,并按照随机数字表法将其分组为对照组和观察组。对照组:采用传统开腹手术治疗;观察组:采用腹腔镜手术治疗。观察和比较2组患者术前和术后第4天CD4/CD8水平和Ig G表达情况。同时观察2组患者术中出血量和手术时间及肛门排气时间、术后自主下床活动时间等。结果治疗后,观察组患者术中出血量和手术时间及肛门排气时间、术后自主下床活动时间、留置尿管时间、平均住院时间分别为(119.52±6.24)ml、(65.21±9.36)min、(0.65±0.12)d、(3.21±0.69)d、(0.59±0.15)d、(12.52±2.36)d,与对照组(351.21±12.02)ml、(98.65±10.21)min、(1.75±0.36)d、(6.32±0.75)d、(2.01±0.27)d、(18.26±3.07)d比较,P<0.05。此外,观察组患者术后发热和并发症的发生率明显低于对照组,且术后第4天,观察组患者CD4/CD8水平和Ig G表达水平与对照组比较,P<0.05。结论相比传统开腹手术来说,腹腔镜手术治疗胃癌创伤小,同时对患者体液免疫和细胞免疫功能影响较小,对患者术后恢复有一定帮助。

Objective To compare the efficacy of open laparotomy and laparoscopic surgery in the treatment of patients with gastric cancer .Methods 66 cases of gastric cancer patients were selected as the research object ,and were divided into the control group and the observation group according to random number table .The control group received the traditional open laparot-omy;the observation group received the laparoscopic surgery .Preoperative and postoperative 4 d CD4/CD8 levels and IgG expres-sion of the 2 groups were observed and compared .Intraoperative blood loss,operation time,anus exhaust time,and postoperative autonomous bed activity time of the 2 groups were observed.Results After treatment,intraoperative blood loss,operation time, anus exhaust time ,postoperative autonomous bed activity time ,time placing a urinary catheter ,average hospitalization time of the observation group were respectively (119.52 ±6.24) ml,(65.21 ±9.36) min and (0.65 ±0.12) d,(3.21 ±0.69) d,(0.59 ±0.15) d,and compared with the control group ,(12.52 ±2.36) d,(351.21 ±12.02) ml,(98.65 ±10.21) min and (1.75 ± 0.36) d,(6.32 ±0.75) d,(2.01 ±0.27) d,(18.26 ±3.07) d comparison,there had significant difference (P<0.05).In ad-dition,postoperative fever rate and complication rate of the observation group were significantly lower than those of the control group;and 4 d after surgery,postoperative CD4/CD8 and IgG levels of the 2 groups had significant difference (P<0.05).Con-clusion Compared with the traditional laparotomy ,laparoscopic surgery for gastric cancer has small trauma and less influence on humoral immunity and cellular immune function ,it is helpful for postoperative recovery .