摘要
目的探讨腹腔镜与开腹胃癌根治术治疗进展期胃癌的临床效果。方法 90例进展期胃癌患者作为研究对象,随机分为对照组和观察组,各45例。对照组行开腹胃癌根治术治疗,观察组行腹腔镜胃癌根治术治疗。比较两组进展期胃癌的治疗效果,手术前后患者生存质量、卡氏评分,术中出血量、住院时间、术后进食时间、止痛药使用量、淋巴结清扫数目以及并发症发生情况。结果观察组进展期胃癌治疗总有效率为100.00%,对照组进展期胃癌治疗总有效率为100.00%,比较差异无统计学意义(P>0.05);对照组手术前生存质量、卡氏评分分别为(45.34±5.02)、(65.04±4.24)分,手术后生存质量、卡氏评分分别为(63.50±9.25)、(71.13±8.28)分;观察组手术前生存质量、卡氏评分分别为(45.24±5.24)、(65.02±4.21)分,手术后生存质量、卡氏评分分别为(84.86±9.11)、(76.15±14.16)分。两组手术后生存质量、卡氏评分均明显高于手术前,差异具有统计学意义(P<0.05);观察组手术后生存质量、卡氏评分均高于对照组,差异具有统计学意义(P<0.05)。观察组术中出血量、住院时间、术后进食时间、止痛药使用量分别为(211.02±10.12)ml、(7.01±2.13)d、(12.02±0.12)h、(6.01±2.11)mg均优于对照组的(298.14±20.24)ml、(9.15±3.57)d、(23.14±0.24)h、(13.15±2.57)mg,差异具有统计学意义(P<0.05);对照组淋巴结清扫数目为(19.62±2.19)个,观察组淋巴结清扫数目为(19.21±2.21)个,比较差异无统计学意义(P>0.05);观察组并发症发生率为8.89%,明显低于对照组的24.44%,差异具有统计学意义(P<0.05)。结论进展期胃癌患者行腹腔镜胃癌根治术疗效肯定,清扫淋巴结可达到和开腹手术相似的效果,缩短术后康复时间,减少术中出血量和止痛药物的使用量,提高患者的生存质量。
Objective To investigate the clinical effect of laparoscopic and open radical gastrectomy for the treatment of advanced gastric cancer. Methods A total of 90 patients with advanced gastric cancer were selected as research objects and randomly divided into control group and observation group, 45 cases in each group. The control group received open radical gastrectomy for treatment, the observation group received laparoscopic radical gastrectomy for treatment. The therapeutic effect of advanced gastric cancer, the quality of life and Karnofsky score before and after surgery, intraoperative blood loss, length of stay, the time of postoperative food intake, dosage of analgesics, number of lymph node dissections and incidence of complications between the two groups were compared. Results The total effective rate of advanced gastric cancer in the observation group was 100.00%, and that in the control group was 100.00%, there was no statistically significant difference（P〉0.05）. The quality of life score and Karnofsky score in the control group before surgery were（45.34±5.02） scores and（65.04±4.24） scores respectively, above indexes after surgery were（63.50±9.25） scores and（71.13±8.28） scores respectively. The quality of life score and Karnofsky score in the observation group before surgery were（45.24±5.24） scores and（65.02±4.21） scores respectively, above indexex after surgery were（84.86±9.11） scores and（76.15±14.16） scores respectively. The quality of life scores and Karnofsky scores in the two groups after surgery were significantly higher than those before surgery, the differences were statistically significant（P〈0.05）. The quality of life score and Karnofsky score in the observation group after surgery were significantly higher than those in the control group, the differences were statistically significant（P〈0.05）. The intraoperative blood loss, length of stay, the time of postoperative food intake and dosage of analgesics in the observation group were（211.02±10.12） ml,（7.01±2.13） d,（12.02±0.12） h and（6.01±2.11） mg respectively, which were significantly less than（298.14±20.24） ml,（9.15±3.57） d,（23.14±0.24） h and（13.15±2.57） mg in the control group, the differences were statistically significant（P〈0.05）. The number of lymph node dissections in the control group and the observation group were（19.62±2.19） and（19.21±2.21） respectively, there was no statistically significant difference（P〉0.05）. The incidence of complications in the observation group was 8.89%, which was significantly lower than 24.44% in the control group, the difference was statistically significant（P〈0.05）. Conclusion The efficacy of laparoscopic radical gastrectomy for advanced gastric cancer is effective, lymph node dissections can achieve the same effect as laparotomy, shorten postoperative recovery time, reduce intraoperative blood loss and use of analgesics, and improve the quality of life of patients.
作者
张兆明
陈小勋
郑逸川
周永淳
杨喜光
张伟
ZHANG Zhao-ming;CHEN Xiao-xun;ZHENG Yi-chuan(Gastroenterological Surgery,The Eighth Affiliated Hospital of Guangxi Medical University,Guigang 537100,China)
出处
《中国实用医药》
2018年第27期1-3,共3页
China Practical Medicine
基金
贵港市科学研究与技术开发计划(项目编号:1209008)
关键词
腹腔镜
开腹
胃癌根治术
进展期胃癌
Laparoscopic
Laparotomy
Radical gastrectomy for gastric cancer
Advanced gastric cancer
