不同清扫方式对胃癌切除术患者创伤程度的影响

Effect of different methods of dissection on the degree of trauma in patients undergoing gastrectomy

目的探讨不同清扫方式对胃癌切除术患者创伤程度的影响。方法选取2015年6月至2019年6月间西安高新医院收治的200例接受胃癌切除术患者,根据采用的胃癌切除方式不同分为三组,采用姑息性切除术治疗的50例患者纳入D0手术组,采用标准胃癌根治术治疗的130例患者纳入D2手术组,采用扩大胃癌根治术治疗的20例患者纳入D3手术组。观察三种不同清扫方式对患者创伤程度的影响。结果 D0组手术中输血量明显高于D2组以及D3组,差异均有统计学意义(均P <0. 05)。但三组患者的手术时间和住院时间比较,差异无统计学意义(P> 0. 05)。三组患者手术前的IL-6与IL-10水平比较,差异无统计学意义(P> 0. 05)。D2组与D3组IL-10水平术后各个时间点均明显高于D1组差异均有统计学意义(均P <0. 05)。三组治疗后术后各个时间点的IL-6水平比较,差异无统计学意义(P> 0. 05)。D0组腹部并发症4例,腹部以外并发症3例,并发症总发生率为14. 0%。D2组腹部并发症15例,腹部以外并发症6例,并发症总发生率是16. 2%,D3组腹部并发症3例,腹部以外并发症1例,并发症总发生率为20. 0%,三组患者并发症发生率比较,差异无统计学意义(P> 0. 05)。结论胃癌切除后采取标准淋巴结清扫以及扩大淋巴结清扫两种方式,与姑息性切除方式比较,不会增加患者手术中的创伤程度与并发症,效果显著。

Objective To investigate the effect of different cleaning methods on the degree of trauma in patients undergoing gastric cancer resection.Methods A total of 200 patients undergoing gastrectomy at Xi’an High-tech Hospital from June 2015 to June 2019 were enrolled.According to the different methods of dissection,the patients were divided into three groups which were palliative gastrectomy group(50 patients,group D0),standard gastrectomy group(130 patients,group D2)and extended radical gastrectomy(20 patients,group D3).The effect of the three different methods of dissection on the degree of trauma was observed.Results The blood transfusion volume was higher in group D0 than in group D2 and group D3(all P<0.05).There was no significant difference in the operation time the length of hospital stay among the three groups(P>0.05).There was no significant difference in IL-6 and IL-10 levels among the three groups before the surgery(P>0.05).However,after the treatment,IL-10 level at each time point was higher in group D2 than in group D0 and group D3(all P<0.05).There was no significant difference in IL-6 level at each time point among the three groups after the surgery(P>0.05).Abdomen associated complications occurred in 4,15 and 3 patents,respectively in group D0 group D2 and group D3 and the complications other than abdomen occurred in 3 patents,6 patents and 1 patient,respectively in group D0 group D2 and group D3 and the overall incidence of complications was 14.0%,16.2%and 20.0%respectively(P>0.05).Conclusion Compared with palliative gastrectomy,standard gastrectomy and extended radical gastrectomy has obvious efficacy without increasing trauma and complications during the surgery.