腹腔镜与开腹胃癌根治术的疗效分析比较

目的分析比较腹腔镜与开腹胃癌根治术疗效。方法回顾性分析行腹腔镜和开腹胃癌根治术治疗72例胃癌患者临床资料，其中腹腔镜组38例，开腹组32例，比较两组患者手术时间、切口长度、出血量、清扫淋巴结数目、住院时间及手术前后c反应蛋白水平。结果所有患者均顺利完成手术，腹腔镜组无中转开腹，无手术死亡。腹腔镜组手术时间长于开腹组，切口长度小于开腹组，出血量少于开腹组，差异有统计学意义（P〈0．05），而清扫淋巴结数目两组比较差异无统计学意义（P〉0．05）。腹腔镜组较开腹组排气时间短，下床活动时间早，术后住院时间短，发生并发症情况少，差异有统计学意义（P〈0．05）。两组患者术前C反应蛋白比较差异无统计学意义（P〉0．05），而两组术后第1，3，5天C反应蛋白均呈先升后降趋势，腹腔镜组明显低于开腹组[（9．33±0．27）mgm比（11．29±0．42）mg／L、（7．16±0．18）mg／L比（9．87±0．65）mg／L、（4．38±0．41）mg／L比（6．97±0．51）mg／L]，差异有统计学意义（P〈0．05）。结论应用腹腔镜行胃癌根治术，具有安全、效果好、恢复快、对患者刺激小等优点。

Clinical effectiveness study of laparoscopic and open radical gastrectomy for gastric cancer patients

Objective To investigate the clinical effectiveness of laparoscopic and open radical gastrectomy for gastric cancer patients. Methods Seventy-two gastric cancer patients who underwent laparoscopic or open radical gastrectomy were enrolled in this study. Laparoscopic radical gastrectomy group had 38 cases, open radical gastrectomy group had 32 cases. The operating time,length of incision,bleeding volume during operation,postoperative hospital stay and the level of C reactive protein were compared. Results All patients were performed operation successfully. No patient transferred open operation in laparoscopic radical gastrectomy group. No death because of operation. The patients in laparoscopic radical gastrectomy group took longer operating time,but shorter length of incision,less bleeding volume during operation, there was significant difference （P 〈 0.05 ）. But the number of clearing lymph nodes between two groups had no significant difference （P 〉 0.05 ）. Compared with open radical gastrectomy group, the patients in laparoscopic radical gastrectomy group had shorter exhaust time, early out-of-bed activity, shorter postoperative hospital stay, lower rate of complication, there was significant difference （P 〈 0.05 ）. The level of C reactive protein before operation had no significant difference between two groups（P 〉 0.05 ）, and level of C reactive protein had the tendency of improve previously and decrease lately. The level of C reactive protein in laparoscopic radical gastrectomy group was significantly lower than that in open radical gastrectomy group at the postoperative 1st,3rd,5th day[ （9.33 ± 0.27） mg/L vs. （11.29 ±0.42） mg/L, （7.16 ± 0.18） mg/L vs. （9.87 ± 0.65 ） mg/L, （4.38 ± 0.41 ） mg/L vs. （6.97 ± 0.51 ） mg/L] （P 〈 0.05 ）. Conclusion Laparoscopic radical gastrectomy is useful in treating gastric cancer for it＇s advantage of better security,better effectiveness, quicker recover and less trauma.