医用胶减少胃癌术后腹腔渗出的随机对照研究

目的探讨医用生物胶在减少胃癌淋巴结廓清术后腹腔渗液的临床价值。方法2002年6月至2003年12月间,采用信封法将70例胃癌D2及D2+术患者随机分成医用胶组(A组,35例)和对照组(B组,35例)。A组在完成胃癌切除、胃周淋巴结廓清后于后腹膜淋巴结清扫区域滴注医用生物胶;B组则不用。观察术后1～5d腹腔引流液量、蛋白定量、红细胞数(RBC)、血红蛋白(Hb)量。结果全组无手术死亡。A组术后1～3d腹腔引流液量和蛋白丢失量明显少于B组(P<0.01);4～5d时两组相仿(P>0.05);但前5d总的腹腔引流液量和蛋白丢失量A组均少于B组(P<0.01)。两组腹腔引流液中RBC和Hb均以术后第1天为高峰,其后逐渐减少,两组比较差异无统计学意义(P>0.05)。结论医用胶可有效减少胃癌淋巴结廓清术后的腹腔渗出,有助于术后的恢复。

Randomized control study of medical adhesive products decreasing postoperative abdominal effusion in patients with gastric cancer

OBJECTIVE: To determine the value of medical adhesive products for decreasing abdominal effusion after clearing up lymph nodes in patients with gastric cancer. METHODS: Seventy patients with gastric cancer and undergoing D(2 ) or D(2 )(+) radical excision were randomly divided into group A and B based on envelope method from June 2002 to December 2003. In group A (n=35),medical adhesive products was dripped on the retroperitoneal regions where perigastic lymph nodes were cleared up, while not in group B(n=35). Four items including the volume of intraperitoneal drainage, the loss of protein, erythrocyte and hemoglobin were compared between group A and B from the first day to the 5th day after operation. RESULTS: No patients died in group A and B. The volume of intraperitoneal drainage and loss of protein in group A were less than those in group B (P< 0.01) from the first day to the 3th day after operation,but there was no significant difference at the 4th day and 5th day after operation(P > 0.05). The total volume of intraperitoneal drainage and loss of protein in group A were less than those in group B (P< 0.01) from the first day to the 5th day after operation. The loss of erythrocyte and hemoglobin reached the peak at the first day after operation both in group A and B, then gradually decreased, so there was no significant difference between group A and B later. CONCLUSION: The medical adhesive products can decrease abdominal effusion effectively after clearing up perigastric lymph nodes and facilitate patients' recovery from operation.