胃癌患者采用腹腔镜D2根治术与开腹手术治疗的效果对照研究

吴磊

[摘要] 目的 对照研究腹腔镜D2根治术与开腹手术治疗胃癌的效果。方法 方便选择2013年9月—2015年9月该院收治60例胃癌患者作为研究对象，根据随机分组的规则，分为观察与对照组，30例对照组实行开腹手术治疗，30例观察组实行腹腔镜D2根治术，对比两组患者手术情况、并发症发生情况、1年后存活情况。 结果 经过手术后，两组手术时间、淋巴结清除数目、1年后存活情况、并发症发生情况差异无统计学意义（P>0.05）；观察组术中出血量、手术切口分别为（148.22±9.51）mL、（5.36±1.22）cm，对照组为（329.54±11.36）mL、（16.52±1.32）cm，观察组明显优于对照组（P<0.05）；观察组胃肠道功能恢复时间、首次进食流质时间、术后住院时间分别为（2.56±0.95）、（4.36±1.14）、（8.62±1.32）d，均明显优于对照组（P<0.05）。结论 腹腔镜D2根治术用于胃癌治疗过程，能够有效减少术中出血量，降低对患者的创伤，缩短其住院时间，且术后恢复速度较快，可推广。

[关键词] 腹腔镜D2根治术；胃癌；开腹手术；治疗效果

[中图分类号] R735.2 [文献标识码] A [文章编号] 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

胃癌屬于临床中发病率较高的恶性肿瘤，在全球占到第二位，该疾病的发病情况存在较为显著的地域差异，东部沿海地带、西北部胃癌的发病机率更高[1]，多发于中老年人群，患者早期的临床症状并不明显，随着病情的进展，会表现为体重减轻、腹部疼痛，伴有黑便、呕血、贫血等其他症状[2]。当前，治疗胃癌的方式有手术与化疗等，在胃癌早期多半会建议患者手术，因此，该文主要以2013年9月—2015年9月该院收治60例胃癌患者为对象，对照腹腔镜D2根治术与开腹手术治疗胃癌的效果，现报道如下。