摘要
目的探讨双通道重建手术对早期胃上部癌患者机体应激反应、术后营养状况及预后的影响。方法抽取2017年1月至2018年12月在河南科技大学第一附属医院接受治疗的早期胃上部癌患者100例, 采用随机数字表法分为观察组和对照组, 每组50例。其中观察组患者采用双通道重建, 对照组患者采用食管管状吻合术, 并对所有患者进行为期3年的跟踪随访调查, 比较两种手术的治疗效果。结果观察组手术时间长于对照组, 恢复流质食物时间以及住院时间短于对照组(P<0.05);两组患者术后排气时间和术中出血量比较差异未见统计学意义(P>0.05)。术中及术后3 d, 观察组血清C反应蛋白、皮质醇水平低于对照组(P<0.05)。术后第3天, 观察组血清血红蛋白(Hb)、总蛋白(TP)水平高于对照组(P<0.05);术后第5天, 两组血清Hb、TP水平比较差异未见统计学意义(P>0.05);术后第1、3、5天, 两组白蛋白水平比较差异未见统计学意义(P>0.05)。观察组贫血发生率为44.00%(22/50), 低于对照组的68.00%(34/50), P<0.05;两组切口感染、肺部感染、术后出血发生率, 及术后1、3年的复发转移率比较差异未见统计学意义(P>0.05)。结论双通道重建手术可有效减少早期胃上部癌患者应激反应, 提高患者术后营养状况, 降低并发症发生率, 且不会提高术后复发风险。
Objective To investigate the effects of dual-channel reconstruction surgery on stress response,postoperative nutritional status and prognosis of patients with early proximal gastric cancer.Methods A total of 100 patients with early proximal gastric cancer treated in the First Affiliated Hospital of Henan University of Science and Technology from January 2017 to December 2018 were enrolled.According to random number table method,they were divided into observation group and control group,with 50 cases in each group.Patients in the observation group underwent double-channel reconstruction surgery,while patients in the control group underwent esophageal tubular anastomosis.All of them were followed up for 3 years to compare the curative effect between the two groups.Results The operation time in the observation group was longer than that in the control group,starting time for eating liquid food and hospitalization time were shorter than those in control group(P<0.05).There was no significant difference in postoperative exhaust time or intraoperative blood loss between the two groups(P>0.05).During surgery and on 3 days after surgery,the levels of serum C-reactive protein and cortisol in the observation group were lower than those in the control group(P<0.05).The levels of serum hemoglobin(Hb)and total protein(TP)in the observation group were higher than those in the control group on the 3rd day after surgery(P<0.05).There was no significant difference in serum Hb and TP level between the two groups on the 5th day after surgery(P>0.05).On the 1st,3rd and 5th day after surgery,there was no significant difference in albumin between the two groups(P>0.05).The incidence of anemia in the observation group was 44.00%(22/50),which was lower than 68.00%(34/50)in the control group(P<0.05).There was no significant difference between the two groups in the incidence of incision infection,incidence of pulmonary infection,incidence of postoperative bleeding and the 1-and 3-year postoperative recurrence and metastasis rate(P>0.05).C
作者
张丽柯
杨利平
张剑锋
Zhang Like;Yang Liping;Zhang Jianfeng(Department of Gastrointestinal Surgery,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China;Department of UrologyⅡ,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China)
出处
《中国实用医刊》
2022年第11期22-26,共5页
Chinese Journal of Practical Medicine
关键词
胃癌
胃上部癌
双通道重建手术
营养状况
应激反应
预后
Stomach neoplasms
Proximal gastric cancer
Early proximal gastric cancer
Dual-channel reconstruction surgery
Nutritional status
Stress response
Prognosis
