摘要
目的探讨腹腔镜辅助胃癌根治术治疗胃癌的应用效果,及其对患者免疫指标及术后微转移的影响。方法选择2015年2月—2020年12月就诊于该院的104例胃癌患者,按随机数字表法分为腹腔镜组(52例)和常规组(52例)。腹腔镜组行腹腔镜下根治术治疗,常规组行开腹胃癌根治术治疗。比较两组手术指标、免疫指标、微转移指标和并发症。结果两组清扫淋巴结数比较,差异无统计学意义(P>0.05),腹腔镜组切口长度为(9.87±1.45)cm、术中出血量为(271.65±87.69)mL,低于常规组,差异有统计学意义(t=21.847、9.592,P<0.05),腹腔镜组手术时间为(260.21±36.57)min,长于常规组,术后肠功能恢复时间为(3.65±0.97)d、住院时间为(10.12±2.26)d、首次下床活动时间为(2.56±0.64)d,短于常规组,差异有统计学意义(t=12.129、5.500、9.726、9.272,P<0.05);腹腔镜组术后CD4^(+)为(11.65±1.24)%、CD4^(+)/CD8^(+)为(3.44±0.21),高于常规组,CD8^(+)为(3.39±0.68)%、多巴胺脱羧酶(DDC)为(122.87±11.65)ng/mL、癌胚抗原(CEA)为(1521.72±224.67)ng/mL,低于常规组,差异有统计学意义(t=3.775、33.372、12.191、20.648、27.832,P<0.05);腹腔镜组术后并发症发生率为3.85%,低于常规组的25.00%,差异有统计学意义(χ^(2)=9.426,P=0.002)。结论与开腹手术相比,对胃癌患者行腹腔镜手术治疗效果更好,其能减小手术创伤,对免疫功能影响小,减小术后微转移发生风险,缩短术后恢复时间。
Objective To explore the effect of laparoscopic-assisted radical gastric cancer treatment for gastric cancer,and its influence on patients'immune indicators and postoperative micrometastasis.Methods A total of 104 gastric cancer patients who were admitted to the hospital from February 2015 to December 2020 were selected and divided into laparoscopic group(52 cases)and routine group(52 cases)according to the random number table method.The laparoscopic group was treated with laparoscopic radical resection,and the conventional group was treated with open gastric cancer radical resection.The surgical indicators,immune indicators,micrometastasis indicators and complications were compared between the two groups.Results There was no statistically significant difference in the number of dissected lymph nodes between the two groups(P>0.05).The incision length in the laparoscopic group was(9.87±1.45)cm,and the intraoperative blood loss was(271.65±87.69)mL,which was lower than that in the conventional group,and the difference were statistically significant(t=21.847,9.592,P<0.05),the operation time of the laparoscopic group was(260.21±36.57)min,which was longer than that of the conventional group,the postoperative bowel function recovery time was(3.65±0.97)d,and the hospitalization time was(10.12±2.26)d.The time to get out of bed for the first time was(2.56±0.64)d,which was shorter than that of the conventional group,and the difference were statistically significant(t=12.129,5.550,9.726,9.272,P<0.05);in the laparoscopic group,CD4^(+)was(11.65±1.24)%,CD4^(+)/CD8^(+)was(3.44±0.21),higher than the conventional group,CD8^(+)was(3.39±0.68)%,and dopamine decarboxylase(DDC)was(122.87±11.65)ng/mL and carcinoembryonic antigen(CEA)was(1521.72±224.67)ng/mL,which were lower than the conventional group,and the difference were statistically significant(t=3.775,33.372,12.191,20.648,27.832,P<0.05);the postop erative complication rate in the laparoscopic group was 3.85%,which was lower than the 25.00%in the conventional group,and the difference was statistically significant(χ^(2)=9.426,P=0.002).Conclusion Compared with open surgery,laparoscopic surgery is more effective for gastric cancer patients.It can reduce surgical trauma,have less impact on immune function,reduce the risk of postoperative micrometastasis,and shorten postoperative recovery time.
作者
戴东华
沈美华
DAI Donghua;SHEN Meihua(Department of Emergency Surgery,Haimen District People's Hospital,Nantong,Nantong,Jiangsu Province,226100 China)
出处
《世界复合医学》
2021年第9期16-19,共4页
World Journal of Complex Medicine
基金
2018年度南通市市级科技计划项目(MSZ18185)。
关键词
胃癌
胃癌根治术
腹腔镜
微转移
免疫指标
Gastric cancer
Radical gastric cancer
Laparoscopy
Micrometastasis
Immune indicators
