腹腔镜手术对胃癌患者术后应激反应的影响研究

目的：通过观察腹腔镜与开腹手术对患者术后炎症因子的影响，探讨腹腔镜胃癌手术对患者术后应激反应的影响。方法：选取2012年1月-2014年6月在本院行胃癌手术的患者100例，按照随机数字表法分为开腹手术组和腹腔镜手术组各50例，记录两组的手术指标（手术时间、术中出血量、术后排气时间、住院天数），监测术前及术后的血清胃饥饿素、TNF-α、IL-6、IL-8及CRP水平。结果：（1）两组患者的手术指标比较差异均具有统计学意义（P〈0.05）；（2）术后两组患者的血清胃饥饿素和TNF-α、IL-6、IL-8、CRP水平升高，并于术后24 h达到峰值，开腹手术组明显高于腹腔镜手术组，差异具有统计学意义（t=2.837、2.904、2.671、2.802、6.374，P〈0.05）。结论：腹腔镜胃癌手术与传统开腹手术相比对患者术后造成应激反应较轻，对患者的创伤较小。

Study on the Effect of Laparoscopic Operation on the Stress Response in Postoperative Patients with Gastric Cancer

Objective：To observe the effect of laparoscopic and open operation on inflammatory factors in patients after laparoscopic operation of gastric cancer,to investigate the effect on the stress reaction of patients after operation. Method：From January 2012 to June 2014 in our hospital ,100 patients with gastric cancer operation were randomly divided into the open operation group and laparoscopic operation group,with 50 cases in each group. The operation index of the two groups（operation time,intraoperative bleeding volume,postoperative exhaust time,hospitalization days） were recorded,the operation pre-and postoperative ghrelin,TNF-α,IL-6,IL-8 and CRP levels were monitored. Result：（1）The operation index in patients of the two groups had statistically significant difference（P〈0.05）. （2）After operation in the two groups,the serum ghrelin and TNF-α,IL-6,IL-8,CRP levels increased,and reached the peak at 24 h after operation,laparoscopic operation were significantly higher than those in the open operation group, with statistical significant differences（t=2.837,2.904,2.671,2.802,6.374,P〈0.05）.Conclusion：Compared with traditional open operation,the laparoscopic operation on postoperative stress reaction is mild,with minor trauma.