摘要
目的探讨不同手术方式治疗胃不利部位胃肠间质瘤(GISTs)的疗效及其对免疫功能的影响。方法选取92例胃不利部位GISTs患者分为腹腔镜组和开腹手术组,每组46例。开腹手术组行开腹GISTs切除术,腹腔镜组于腹腔镜下行GISTs切除术。观察2组患者手术指标、炎症反应和免疫功能指标,术后并发症、术后1年复发率和存活率。结果腹腔镜组术中出血量少于开腹手术组,术后首次排气时间、住院时间均短于开腹手术组,差异有统计学意义(P<0.05)。术后,腹腔镜组免疫球蛋白A(IgA)、免疫球蛋白G(IgG)水平均高于开腹手术组,C反应蛋白(CRP)、白细胞介素-6(IL-6)水平均低于开腹手术组,差异有统计学意义(P<0.05)。腹腔镜组术后并发症发生率为8.68%,低于开腹手术组的23.91%,差异有统计学意义(P<0.05)。结论腹腔镜下胃肠间质瘤切除术治疗胃不利部位GISTs患者疗效显著,可以减少术中出血量,完整切除病变组织,有利于术后恢复胃肠道功能,缩短住院时间,降低术后并发症发生率。
Objective To explore efficacy of different surgical methods for gastric gastrointestinal stromal tumors(GISTs)at unfavorable positions and their impact on immune function.Methods A total of 92 patients with GISTs at unfavorable positions were selected and divided into laparoscopic group and laparotomy group,with 46 cases in each group.The laparotomy group underwent open GISTs resection,and the laparoscopic group underwent laparoscopic GISTs resection.Surgical indicators,inflammatory response and immune function indicators,postoperative complications,postoperative recurrence rate and survival rate at 1 year after operation were observed in the two groups.Results The intraoperative blood loss in the laparoscopic group was significantly less than that in the laparotomy group,and the postoperative first exhaust time and hospital stay in the laparoscopic group were significantly shorter than those in the laparotomy group(P<0.05).After surgery,the levels of immunoglobulin A(IgA)and immunoglobulin G(IgG)in the laparoscopic group were significantly higher than those in the laparotomy group,and the levels of C-reactive protein(CRP)and interleukin-6(IL-6)were significantly lower than those in the laparotomy group(P<0.05).The incidence of postoperative complications in the laparoscopic group was 8.68%,which was significantly lower than 23.91%in the laparotomy group(P<0.05).Conclusion Laparoscopic resection of GISTs has a definite therapeutic effect for patients with GISTs at unfavorable positions of the stomach.It can reduce intraoperative blood loss,completely remove the diseased tissue,shorten the length of hospital stay and reduce postoperative complication.Besides,the surgery is conducive to postoperative recovery of gastrointestinal function.
作者
程国凌
王松松
CHENG Guoling;WANG Songsong(Department of Emergency Medicine,Huiji Division of First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan,450000)
出处
《实用临床医药杂志》
CAS
2020年第21期5-8,共4页
Journal of Clinical Medicine in Practice
关键词
腹腔镜
胃不利部位
胃肠间质瘤
首次排气时间
术中出血
laparoscope
unfavorable positions of the stomach
gastrointestinal stromal tumors
time to first exhaustion
intraoperative bleeding
