摘要
目的探讨腹腔镜辅助胃癌根治术、开腹胃癌根治术对老年胃癌患者近期疗效及炎症反应的影响。方法选取2022年1月至2024年12月抚州市第一人民医院收治的80例老年胃癌患者作为研究对象,按照随机数表法分为对照组与观察组,每组40例。对照组采用开腹胃癌根治术,观察组采用腹腔镜辅助胃癌根治术。比较两组临床指标、免疫指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、炎症因子[白细胞介素-6(interleukin-6,IL-6)、WBC及肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]、生命质量[健康调查量表36(36-item short form health survey,SF-36)]、并发症发生情况及复发率。结果观察组术中出血量少于对照组,术后肠道功能恢复时间短于对照组,差异有统计学意义(P<0.05),两组手术时间比较差异无统计学意义。术后7 d,两组CD4^(+)、CD4^(+)/CD8^(+)均低于术前,CD8^(+)均高于术前,但观察组高于对照组,差异有统计学意义(P<0.05)。术后24 h,两组IL-6、WBC、TNF-α水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05)。术后,两组生理、心理领域评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。两组术后6、12个月复发率比较差异无统计学意义。结论腹腔镜辅助胃癌根治术治疗老年胃癌患者,可减少术中出血量,加速肠道功能恢复,减轻对免疫指标的不利影响,缓解炎症反应,并改善患者生命质量,具有临床推广价值。
Objective To investigate the short-term efficacy of laparoscopic assisted radical gastrectomy and open radical gastrectomy for gastric cancer in elderly patients with gastric cancer and its effect on inflammatory response.Methods 80 elderly patients with gastric cancer admitted to Fuzhou First People's Hospital from January 2022 to December 2024 were selected as the research subjects,and they were divided into the control group and the observation group according to the random number table method,with 40 cases in each group.The control group was treated with open radical gastrectomy,and the observation group was treated with laparoscopic assisted radical gastrectomy.The clinical indexes,immune indexes(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),inflammatory factors(interleukin-6[IL-6],WBC,tumor necrosis factor-α[TNF-α]),quality of life(36-item short form health survey[SF-36]),complications and recurrence rate were compared between the two groups.Results The amount of bleeding in the observation group was less than that in the control group,and the recovery time of intestinal function after operation was shorter than that in the control group,the differences were statistically significant(P<0.05),there was no significant difference in operation time between the two groups.7 d after operation,the levels of CD4^(+),CD4^(+)/CD8^(+)of the two groups were lower than those before operation,and CD8^(+)was higher than that before operation,but the observation group was higher than the control group,the differences were statistically significant(P<0.05).24 h after operation,the levels of IL-6,WBC and TNF-αof the two groups were higher than those before operation,but the observation group was lower than the control group,the differences were statistically significant(P<0.05).After operation,the scores of physiological and psychological fields of the two groups were higher than those before operation,and the observation group was higher than the control group,the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in recurrence rate between the two groups at 6 and 12 months after operation.Conclusion Laparoscopic assisted radical gastrectomy for elderly patients with gastric cancer can reduce intraoperative blood loss,accelerate the recovery of intestinal function,reduce the adverse effects on immune indicators,alleviate inflammation,and improve the quality of life of patients,it has clinical promotion value.
作者
胡志勇
桂欣
吴烨
许岩
曾应文
HU Zhiyong;GUI Xin;WU Ye;XU Yan;ZENG Yingwen(Department of General Surgery,Fuzhou First People's Hospital,Fuzhou,Jiangxi,344000,China)
出处
《当代医学》
2025年第31期89-93,共5页
Contemporary Medicine
基金
江西省卫生健康委科技计划项目(202411012)。
关键词
腹腔镜辅助胃癌根治术
开腹胃癌根治术
老年
胃癌
炎症反应
Laparoscopic assisted radical gastrectomy for gastric cancer
Open radical gastrectomy for gastric cancer
Old age
Gastric cancer
Inflammatory response
