87例腹腔镜胃癌手术患者的临床疗效分析

目的 探讨腹腔镜胃癌手术的临床疗效.方法 选择胃癌患者87例为研究对象,根据治疗方法不同将患者分为观察组(n=45)与对照组(n=42),观察组患者接受腹腔镜手术治疗,对照组患者接受开腹手术治疗,比较分析两组患者手术前后国际标准化比值(INR)、血清活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、D-二聚体(D-D)、纤维蛋白原(FIB)的变化情况及术前、术后6 h、术后24 h的肿瘤坏死因子-α(TNF-α)、血清白细胞介素-6(IL-6)、血清白细胞介素-8(IL-8)水平变化情况,并根据两组患者的基本情况判定疗效.结果 术后,两组患者的INR、APTT及PT值均较本组术前降低,D-D、FIB水平均较本组术前升高,且观察组的INR、APTT及PT值低于对照组(P<0.05),D-D、FIB水平高于对照组(P<0.05);术后6 h,两组患者血清中的TNF-α、IL-6、IL-8水平均较本组术前升高,术后24 h,各指标水平均逐渐降低,术后6 h、术后24 h观察组的TNF-α、IL-6、IL-8水平均低于对照组(P<0.05).结论 腹腔镜手术治疗胃癌的临床疗效显著,术后炎性因子介质的释放有所减少,对机体免疫功能影响小,但对患者的凝血功能影响较大,治疗时应采取相应措施预防凝血功能异常导致的血栓.

Clinical efficacy analysis of 87 cases of laparoscopic gastric surgery

Objective To investigate the clinical efficacy of laparoscopic gastric surgery. Method 87 cases of gas-tric cancer were treated with laparoscopic surgery (study group, n=45) or open surgery (control group, n=45) for gastric cancer, and the changes of INR, APTT, PT, D-D, FIB, as well as the levels of TNF-α, IL-6 and IL-8 before and 6 h, 24 h after surgery were compared to determine the clinical efficacy based on the general conditions of the two groups of pa-tients. Result The INR, APTT and PT levels were decreased, while D-D and FIB were increased in both groups after sur-gery, and lower levels of INR, APTT and PT, but higher levels of D-D and FIB were observed in study group than those of the control group (P<0.05);In 6 h after surgery, the two groups of patients had elevated serum TNF-α, IL-6 and IL-8, which were decreased gradually in 24 h after surgery, it was notable that the levels of TNF-α, IL-6 and IL-8 in study group were lower compared with control group at 6 h and 24 h after surgery (P<0.05). Conclusion The clinical efficacy of laparoscopic surgery for gastric cancer is significant, with decreased release of inflammatory cytokines media, and mi-nor impact on immune function, but it markedly affects patients'blood coagulation, so specific measures should be ad-ministered to prevent the formation of thrombus caused by coagulation abnormalities.