摘要
目的探讨腹腔镜胃癌根治术治疗进展期胃癌及对患者相关指标的影响。方法选取本院2015年1月至2018年12月收治的90例进展期胃癌作为研究对象,采用随机数字法分为观察组和对照组,各45例,其中对照组进行常规开腹手术,观察组则进行腹腔镜胃癌根治术。观察并记录两组患者的手术一般情况,包括术中出血量、手术时间、术后排气时间、下床活动时间以及住院时间;记录并比较两组患者术后6 h、12 h、24 h、48 h的VAS评分;检测并比较两组患者术后CD3~+、CD4~+、CD8~+、CD4~+/CD8~+、NK等免疫功能指标;观察并比较两组患者术后并发症的发生情况。结果观察组患者术中出血量、手术时间、术后排气时间、下床活动时间以及住院时间均明显小于对照组,差异均具有统计学意义(P<0.05)。观察组患者术后6 h、12 h、24 h、48 h的VAS评分明显低于对照组,差异均具有统计学意义(P<0.05)。两组患者术后的CD3~+、CD8~+数值比较,差异无统计学意义;观察组患者术后CD4~+、CD4~+/CD8~+、NK数值均明显优于对照组,差异具有统计学意义(P<0.05)。观察组患者术后切口感染1例、肺部感染1例;对照组患者术后切口感染3例,腹腔感染2例,尿路感染2例、肺部感染和吻合口瘘各1例;观察组术后不良反应发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论腹腔镜胃癌根治术治疗进展期胃癌效果显著,不仅对患者的免疫功能影响较小,而且还能降低患者的术后疼痛,减少术后并发症的发生。
Objective To investigate the effect of laparoscopic radical gastrectomy on advanced gastric cancer and related indicators. Methods 90 cases of patients with advanced gastric cancer admitted to our hospital from January 2015 to December 2018 were selected as the research objects.They were randomly divided into observation group and control group with 45 cases in each group. The control group were given routine laparotomy,while the observation group were given laparoscopic radical gastrectomy. The general operation conditions including intraoperative bleeding volume,operation time, postoperative exhaust time, time to get out of bed and stay in hospital of the two groups were observed and recorded. VAS scores at 6,12, 24 and 48 hours after operation were recorded and compared between the two groups. Immune function indexes such as CD3~+, CD4~+, CD8~+, CD4~+/CD8~+, NK were detected and compared between the two groups. The occurrence of postoperative complications was observed and compared between the two groups. Results The blood volume, operation time, exhaust time, time to get out of bed and stay in hospital of the patients in the observation group were significantly less than those in the control group, and the difference was statistically significant(P<0.05). The VAS scores of the patients in the observation group at 6, 12, 24 and 48 hours after operation were significantly lower than those in the control group, the difference was statistically significant(P<0.05). Although there was no significant difference in the values of CD3~+, CD8~+ between the two groups, but the values of CD4~+,CD4~+/CD8~+, NK in the observation group were significantly better than those in the control group, the difference was statistically significant(P<0.05). There were 1 case of incision infection and 1 case of pulmonary infection in the observation group, 3 cases of incision infection, 2 cases of abdominal infection, 2 cases of urinary tract infection, 1 case of pulmonary infection and 1 case of anastomotic leakage in the control group. The incidence of adverse reactions in the observation group was significantly lower than that in the control group, the difference was statistically significant(P<0.05). Conclusion Laparoscopic radical gastrectomy is effective in the treatment of advanced gastric cancer, it not only has little influence on the immune function of patients, but also can reduce the pain and complications of patients after operation.
引文
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