不同手术对胃肠间质瘤的疗效及患者围术期指标、预后的影响

目的 探讨不同手术对胃肠间质瘤 (GIST) 的疗效及患者围术期指标、预后的影响.方法 选取2006年10月至2016年11月成都医学院第一附属医院收治的GIST患者60例为研究对象, 依据手术方式不同将其分为研究组 (n=35, 行腹腔镜手术) 、对照组 (n=25, 行开腹手术) , 记录2组围术期指标、手术前后胃肠功能[胃泌素 (GAS) 、胃动素 (MTL) 、血管活性肠肽 (VIP) ]、术后复发危险度分级及并发症发生情况.结果 2组手术时间比较差异无统计学意义 (P>0.05) , 研究组术中出血量、术后3 d疼痛评分低于对照组, 而术后排气时间、进流食时间、住院时间短于对照组 (P<0.05) ;术后研究组血浆GAS、MTL、VIP水平较对照组高 (P<0.05) ;2组术后复发危险度分级、并发症发生率比较差异无统计学意义 (P>0.05) .结论 与传统开腹手术比较, 腹腔镜手术治疗GIST疗效较好, 具有创伤小、疼痛轻、术后胃肠功能恢复快等优势, 且不会增加远期复发危险、并发症, 有较好的应用前景.

Efficacy of Different Surgeries for Gastrointestinal Stromal Tumors and their Effects on Perioperative Indexes and Prognosis

Objective To explore the efficacy of different surgeries for gastrointestinal stromal tumors (GIST) and their effects on perioperative indexesand prognosis. Methods 60 cases of GIST patients admitted in our hospital from October 2006 to November 2016 were selected and were divided into the study group (n =35, given the laparoscopic surgery) and the control group ( n =25, given the laparotomy) . The perioperative indexes, gastrointestinal function before and after operation [ (gastrin (GAS) , motilin (MTL) , vasoactive intestinal peptide (VIP) ], postoperative recurrence risk grade and complications were recorded in the two groups. Results There was no significant difference between the two groups in the operation time (P>0.05) , and the intraoperative blood loss volume and postoperative 3 d pain score in the study group were lower than those in the control group, and the postoperative exhaust time, eating time and hospital stay were shorter than those in the control group (P<0.05) . The levels of plasma GAS, MTL and VIP in the study group were higher than those in the control group after operation (P<0.05) . There was no significant difference in the postoperative recurrence risk grade and the incidence rate of complications between the two groups (P>0.05) . Conclusions Compared with the conventional laparotomy, laparoscopic surgery has better efficacy for GIST and has advantages of small trauma, mild pain and fast postoperative gastrointestinal function recovery, and it will not increase the risk of long-term recurrence and complications, therefore it has a good application prospect.