摘要
目的分析腹腔镜微创手术在胰腺癌新辅助化疗中的作用。方法纳入2022年8月—2024年8月就诊于吉林省人民医院肝胆胰外科的48例胰腺癌患者,均行新辅助化疗,根据化疗后手术方式分成对照组和观察组。对照组(n=24)采用开腹手术,观察组(n=24)接受腹腔镜手术,比较2组围术期指标、肿瘤标志物水平、应激反应指标和并发症发生率。结果观察组手术时间、下床活动时间、首次进食时间和住院时间分别为(90.16±10.35)min、(11.45±2.36)h、(14.78±2.75)h、(5.15±0.72)d,对照组分别为(111.54±14.72)min、(17.56±3.18)h、(25.44±3.56)h、(7.21±1.18)d,观察组短于对照组,观察组术中出血量为(55.80±11.64)mL,少于对照组的(131.27±20.42)mL,差异均有统计学意义(P<0.05)。观察组术后皮质醇水平、肾上腺素水平和去甲肾上腺素水平分别为(782.28±32.16)nmol/L、(356.36±24.98)pmol/L、(4714.82±185.27)pmol/L,对照组分别为(856.21±35.44)nmol/L、(398.27±22.18)pmol/L、(4972.56±192.24)pmol/L,观察组均低于对照组,差异均有统计学意义(P<0.05)。结论腹腔镜手术联合新辅助化疗方案可改善胰腺癌患者围术期指标,既可降低肿瘤标志物水平,也可减少机体应激反应,保障患者安全。
Objective To analyze the role of laparoscopic minimally invasive surgery in neoadjuvant chemotherapy for pancreatic cancer.Methods A total of 48 patients with pancreatic cancer were included,who attended the department of hepatobiliary and pancreatic surgery of Jilin Provincial People's Hospital from Aug 2022 to Aug 2024,and all of them underwent neoadjuvant chemotherapy,and were divided into the control group and the observation group according to the surgical methods after chemotherapy.The control group(n=24)was operated with open surgery,and the observation group(n=24)received laparoscopic surgery,compared the perioperative indexes,tumor marker levels,stress response indexes,and complication rates between the two groups,and the quality of life of the two groups was also included in the comparison items.Results The operation time,time to ambulation,time to first feeding,and length of hospital stay in the observation group were(90.16±10.35)minutes,(11.45±2.36)hours,(14.78±2.75)hours,and(5.15±0.72)days,respectively,while those in the control group were(111.54±14.72)minutes,(17.56±3.18)hours,(25.44±3.56)hours,and(7.21±1.18)days,respectively.All the above indicators in the observation group were shorter than those in the control group.Additionally,the intraoperative blood loss in the observation group was(55.80±11.64)mL,which was less than(131.27±20.42)mL in the control group.All differences were statistically significant(P<0.05).The levels of cortisol,adrenaline,and noradrenaline in the observation group after surgery were(782.28±32.16)nmol/L,(356.36±24.98)pmol/L,and(4714.82±185.27)pmol/L,respectively,whereas those in the control group were(856.21±35.44)nmol/L,(398.27±22.18)pmol/L,and(4972.56±192.24)pmol/L,respectively.All the above indicators in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).Conclusion The combination of laparoscopic surgery and neoadjuvant chemotherapy can improve the perioperative indicators of pancreatic cancer patients,which can not only reduce the level of tumor markers,but also reduce the body's stress response and ensure patient safety.
作者
齐峰
邓攀
QI Feng;Deng Pan(Department of Hepatobiliary and Pancreatic Surgery,Jilin Provincial People's Hospital,Changchun Jilin 130021,China)
出处
《中国卫生标准管理》
2025年第22期104-108,共5页
China Health Standard Management
关键词
胰腺癌
新辅助化疗
腹腔镜手术
肿瘤标志物
应激反应
并发症
pancreatic cancer
neoadjuvant chemotherapy
laparoscopic surgery
tumor markers
stress response
complications
