腹腔镜与开腹胃癌根治术疗效对比分析

目的探讨腹腔镜与开腹胃癌根治术治疗胃癌的疗效对比分析。 方法回顾性分析2012年3月至2017年3月收治的胃癌患者98例，根据手术方法不同分为开腹组和腹腔镜组，每组49例。数据统计分析采用SPSS19.0进行处理，术中术后指标采用( ±s)进行统计描述，组间比较采用独立t检验；并发症等计数资料采用χ²检验，P<0.05表示差异具有统计学意义。 结果腹腔镜组患者手术切口长度、肛门排气时间、下床时间、引流管拔除时间及住院时间均短于开腹组，术中出血量和使用止痛药次数少于开腹组，但手术时间长于开腹组(P<0.05)。两组患者清扫淋巴结数及近、远切端距肿瘤距离比较差异无统计学意义(P>0.05)。两组患者术后3 d时CRP、TNF－α及IL－6水平较术前上升，腹腔镜组患者3个指标水平均低于开腹组患者(P<0.05)。开腹组患者术后3 d时NO和ET水平高于术前和腹腔镜组患者(P<0.05)。腹腔镜组患者NO和ET水平与术前比较差异无统计学意义(P>0.05)。腹腔镜组患者术后并发症率为6.12%低于开腹组患者18.4%(P<0.05)。 结论腹腔镜胃癌根治术具有手术时间短、切口小，应激反应小，恢复快的特点，同时对机体的免疫功能影响较小。

Comparative analysis of curative effect of laparoscopic and open radical resection of gastric cancer

ObjectiveTo study the curative effect of laparoscopic and open radical gastrectomy in the treatment of gastric cancer. Methods98 cases of gastric cancer from March 2012 to March 2017 were retrospectively analyzed. According to the different surgical methods, 98 patients were divided into open group and laparoscopic group, 49 cases in each group.The statistical analysis was done by SPSS19.0, the measurement index was described by ( ±s), the group t test was used to compare the data among groups, and the count data was analyzed by χ² test. ResultsThe length of incision, the time of anal exhaust, the time of getting out of bed, the time of extubation of drainage tube and the time of hospitalization were shorter in the laparoscopic group than in the open group. The amount of bleeding during operation and the times of using painkillers in the laparoscopy group were less than those in the open group, but the operative time was longer than that in the open group (P<0.05). There was no significant difference in the number of dissected lymph nodes and the distance from the distal end to the tumor between the two groups (P>0.05). The levels of CRP TNF-α and IL-6 increased 3 days after operation in both groups, and CRP in laparoscopic group. The levels of TNF-α and IL-6 were lower than those in the open group (P<0.05), and the levels of no and et in the open group were higher than those in the preoperative group and the laparoscopic group (P<0.05). There was no significant difference in no and et levels between the laparoscopic group and the preoperative group (P>0.05). The postoperative complication rate was 6.12% in the laparoscopic group and 18.4% in the open group (P <0.05). ConclusionLaparoscopic radical resection of gastric cancer has the characteristics of short operation time , small incision , small stress response and fast recovery , and has less influence on the immune function of the organism .