摘要
目的研究微创远端胃癌手术结合D2淋巴结清扫治疗胃癌的效果。方法选取2018年6月至2020年6月本院收治的98例胃癌患者作为研究对象,随机将其分为对照组与观察组,各49例。对照组给予常规开放式手术联合D2淋巴结清扫治疗,观察组给予微创远端胃癌手术结合D2淋巴结清扫治疗。比较两组患者的手术效果指标(手术时间、术中失血量、术后排气时间、开始下床活动时间、住院时间、淋巴结清扫个数)、肿瘤标志物[癌胚抗原(CEA)、糖链抗原19-9(CA19-9)、糖链抗原50(CA50)]水平、并发症发生情况与应激反应指标[8-异前列腺素(8-isoPG)、皮质醇(Cor)、丙二醛(MDA)]水平。结果观察组的手术时间、术中失血量、术后排气时间、开始下床活动时间、住院时间均优于对照组,差异具有统计学意义(P<0.05);两组的淋巴结清扫个数比较,差异无统计学意义(P>0.05)。治疗前,两组的CEA、CA19-9、CA50水平比较,差异无统计学意义(P>0.05);治疗后,两组的CEA、CA19-9、CA50水平均降低,且观察组低于对照组,差异具有统计学意义(P<0.05)。观察组的并发症总发生率为8.16%,低于对照组的24.49%,差异具有统计学意义(P<0.05)。术前1 d,两组的8-isoPG、Cor、MDA水平比较,差异无统计学意义(P>0.05);术后24 h,观察组的8-isoPG、Cor、MDA水平均低于对照组,差异具有统计学意义(P<0.05)。结论微创远端胃癌手术结合D2淋巴结清扫治疗胃癌的效果显著,能够降低并发症总发生率,提高手术安全性,降低患者的肿瘤标志物及应激反应水平,值得临床推广应用。
Objective To study the effect of minimally invasive distal gastric cancer surgery combined with D2 lymph node dissection in the treatment of gastric cancer. Methods A total of 98 patients with gastric cancer treated in our hospital from June 2018 to June 2020 were selected as the research objects and randomly divided into control group and observation group, with 49 cases in each group. The control group was treated with conventional open surgery combined with D2 lymph node dissection, and the observation group was treated with minimally invasive distal gastric cancer surgery combined with D2 lymph node dissection. The surgical effect indexes(operation time, intraoperative blood loss,postoperative exhaust time, starting out of bed activity time, hospital stay and the number of lymph node dissection),tumor markers [carcinoembryonic antigen(CEA), sugar chain antigen 19-9(CA19-9), sugar chain antigen 50(CA50)]levels, complications and stress response indexes [8-iso-prostaglandin(8-isoPG), cortisol(Cor), malondialdehyde(MDA)]levels of the two groups were compared. Results The operation time, intraoperative blood loss, postoperative exhaust time,starting out of bed activity time and hospital stay in the observation group were better than those in the control group,and the differences were statistically significant(P <0.05);there was no significant difference in the number of lymph node dissection between the two groups(P>0.05). Before treatment, there were no significant differences in the levels of CEA, CA19-9 and CA50 between the two groups(P>0.05);after treatment, the levels of CEA, CA19-9 and CA50 in the two groups decreased, and those in the observation group were lower than the control group, and the differences were statistically significant(P <0.05). The total incidence of complications in the observation group was 8.16%, which was lower than 24.49% in the control group, and the difference was statistically significant(P <0.05). One day before operation, there were no significant differences in the levels of 8-isoPG, Cor and MDA between the two groups(P>0.05);at 24 h after operation, the levels of 8-isoPG, Cor and MDA in the observation group were lower than those in the control group, and the differences were statistically significant(P <0.05). Conclusion Minimally invasive distal gastric cancer surgery combined with D2 lymph node dissection in the treatment of gastric cancer has a significant effect, it can reduce the total incidence of complications, improve the safety of surgery, and reduce the tumor markers and stress response levels of patients, which is worthy of clinical promotion and application.
作者
鱼永宾
朱虎
李杰
YU Yongbin;ZHU Hu;LI Jie(the Hospital of Gaoling District,Xi'an 710200;the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)
出处
《临床医学研究与实践》
2022年第4期63-66,共4页
Clinical Research and Practice
关键词
胃癌
微创远端胃癌手术
D2淋巴结清扫
肿瘤标志物
术后应激反应
gastric cancer
minimally invasive distal gastric cancer surgery
D2 lymph node dissection
tumor markers
postoperative stress response
