摘要
目的比较全腔镜远端胃癌根治术(TLDG)与腹腔镜辅助远端胃癌根治术(LADG)在消化道重建中的临床效果。方法采用回顾性分析方法,以2018年1月至2021年1月邯郸市第一医院收治的80例胃癌患者为研究对象,根据治疗方式不同分为对照组(n=40)与研究组(n=40)。对照组行LADG治疗,研究组行TLDG治疗。比较两组患者术中情况(淋巴结个数、肿瘤大小、出血量、切口长度、手术时间)、手术前后应激反应指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C-反应蛋白(CRP)、白细胞计数(WBC)]水平、生活质量评分(躯体机能、躯体职能、躯体疼痛、一般健康、活力、社会功能、情感角色限制、心理健康)变化与术后情况(止痛药使用时间、进食流质时间、排气时间、住院时间、并发症发生率)。结果研究组患者切口长度、手术时间明显短于对照组,差异均有统计学意义(P<0.05);两组患者术中出血量、淋巴结个数、肿瘤大小比较,差异均无统计学意义(P>0.05)。术前,两组患者TNF-α、IL-6、CRP、WBC水平、生活质量评分差异无统计学意义(P>0.05);术后,两组术后TNF-α、IL-6、CRP、WBC水平与生活质量评分明显高于术前,差异均有统计学意义(P<0.05);研究组术后TNF-α、IL-6、CRP、WBC水平低于对照组,生活质量评分高于对照组,差异均有统计学意义(P<0.05)。研究组患者止痛药使用时间、进食流质时间、排气时间、住院时间明显短于对照组,差异均有统计学意义(P<0.05);两组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论TLDG在消化道重建中的应用效果明显优于LADG,手术时间及切口长度更短,可减轻患者术后应激反应,促使其术后快速恢复,并提升生活质量。
Objective Comparison of the clinical effects of total laparoscopic radical gastric cancer resection(TLDG)and laparoscopic-assisted radical gastric cancer(LADG)in gastrointestinal reconstruction.Methods Retrospective analysis was used to study 80 patients with gastric cancer who were admitted to Handan First Hospital from January 2018 to January 2021,and they were divided into control group(n=40)and study group(n=40)according to treatment methods.The control group was treated with LADG treatment.The study group was treated with TLDG treatment.Intraoperative conditions(number of lymph nodes,tumor size,blood loss,length of incision,operation time),stress response indexes[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP),white blood cell count(WBC)]levels,quality of life scores(physical function,physical function,physical pain,general health,vitality,social function,emotional role limitations,mental health)changes before and after operation and postoperative conditions(time to pain medication,time to fluid intake,time to exhaust,hospital stay,complication rate)were compared.Results The length of incision and operation time in the study group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in intraoperative blood loss,number of lymph nodes and tumor size between the two groups(P>0.05).Before surgery,there was no significant difference in the levels of TNF-α,IL-6,CRP,WBC and quality of life score between the two groups(P>0.05).Compared with before operation,the postoperative levels of TNF-α,IL-6,CRP,WBC and quality of life score were higher in both groups after operation,and the differences were significant(P<0.05).The postoperative levels of TNF-α,IL-6,CRP and WBC in the study group were lower than those in the control group,and the quality of life scores were higher than those in the control group,and the differences were significant(P<0.05).The time to pain medication,time to fluid
作者
孙江华
李东辉
刘世浩
王自涛
SUN Jiang-hua;LI Dong-hui;LIU Shi-hao(Department of General Surgery,Handan First Hospital,Handan Hebei 056001,China)
出处
《临床和实验医学杂志》
2022年第5期497-501,共5页
Journal of Clinical and Experimental Medicine
基金
河北省科技重点研发计划项目(编号:172777150)。
关键词
胃癌
消化道重建
全腔镜远端胃癌根治术
腹腔镜辅助远端胃癌根治术
生活质量
Gastric cancer
Digestive tract reconstruction
Full laparoscopic distal gastric cancer radical resection
Laparoscopic assisted distal gastric cancer radical resection
Quality of life
