胃癌患者采用腹腔鏡D2根治術與開腹手術治療的效果對照研究

吳磊

[摘要] 目的 對照研究腹腔鏡D2根治術與開腹手術治療胃癌的效果。方法 方便選擇2013年9月—2015年9月該院收治60例胃癌患者作為研究對象，根據隨機分組的規則，分為觀察與對照組，30例對照組實行開腹手術治療，30例觀察組實行腹腔鏡D2根治術，對比兩組患者手術情況、并發癥發生情況、1年后存活情況。 結果 經過手術后，兩組手術時間、淋巴結清除數目、1年后存活情況、并發癥發生情況差異無統計學意義（P>0.05）；觀察組術中出血量、手術切口分別為（148.22±9.51）mL、（5.36±1.22）cm，對照組為（329.54±11.36）mL、（16.52±1.32）cm，觀察組明顯優于對照組（P<0.05）；觀察組胃腸道功能恢復時間、首次進食流質時間、術后住院時間分別為（2.56±0.95）、（4.36±1.14）、（8.62±1.32）d，均明顯優于對照組（P<0.05）。結論 腹腔鏡D2根治術用于胃癌治療過程，能夠有效減少術中出血量，降低對患者的創傷，縮短其住院時間，且術后恢復速度較快，可推廣。

[關鍵詞] 腹腔鏡D2根治術；胃癌；開腹手術；治療效果

[中圖分類號] R735.2 [文獻標識碼] A [文章編號] 1674-0742（2017）04（c）-0010-03

[Abstract] Objective To compare the effect of laparoscopic D2 total radical gastrectomy and open surgery in treatment of patients with gastric cancer. Methods Convenient selection 60 cases of patients with gastric cancer admitted and treated in our hospital from September 2013 to September 2015 were selected and randomly divided into two groups with 30 cases in each， the observation group and the control group were respectively treated with laparoscopic D2 total radical gastrectomy and open surgery， and the operation situation， occurrence of complications and 1-year survival situation were compared between the two groups. Results After operation， the differences in the operation time， lymph gland removal number， survival situation after 1-year and occurrence of complications were not statistically significant（P>0.05）， and the intraoperative bleeding amount and operation cut in the observation group were obviously better than those in the control group[（148.22±9.51）ml，（5.36±1.22）cm vs （329.54±11.36）mL，（16.52±1.32）cm]（P<0.05）， and the gastrointestinal tract function recovery time， time of first eating fluid and postoperative length of stay in the observation group were respectively （2.56±0.95），（4.36±1.14），（8.62±1.32）d， which were obviously better than those in the control group（P<0.05）. Conclusion The laparoscopic D2 total radical gastrectomy in treatment of patients with gastric cancer can effectively reduce the intraoperative bleeding amount， reduce the trauma of patients， shorten the length of stay and the postoperative recovery is rapid， which can be promoted.

[Key words] Laparoscopic D2 total radical gastrectomy； Gastric cancer ； Open surgery； Treatment effect

胃癌屬于臨床中發病率較高的惡性腫瘤，在全球占到第二位，該疾病的發病情況存在較為顯著的地域差異，東部沿海地帶、西北部胃癌的發病機率更高[1]，多發于中老年人群，患者早期的臨床癥狀并不明顯，隨著病情的進展，會表現為體重減輕、腹部疼痛，伴有黑便、嘔血、貧血等其他癥狀[2]。當前，治療胃癌的方式有手術與化療等，在胃癌早期多半會建議患者手術，因此，該文主要以2013年9月—2015年9月該院收治60例胃癌患者為對象，對照腹腔鏡D2根治術與開腹手術治療胃癌的效果，現報道如下。