2017 年第 1 期 第 15 卷

87例腹腔镜胃癌手术的临床疗效分析

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关键词：腹腔镜胃癌凝血功能炎症因子

• 摘要：
• 【摘要】目的: 探讨腹腔镜胃癌手术的临床疗效。方法：选择2012年7月至2015年6月我院治疗的胃癌患者87例为研究对象，观察组45例患者为接受腹腔镜治疗，对照组给予42例患者为接受开腹术治疗，比较分析两组患者治疗前后的INR、APTT、PT、D-D、FIB等凝血因子的变化情况，术前、术后6h、术后24h的TNF-α、IL-6及IL-8水平情况，及根据两组患者的基本情况判定疗效。结果：术后，两组患者的INR、APTT及PT水平均有明显降低，且观察组更低于对照组，而术后两组患者的D-D和FIB水平均明显升高，且观察组更高于对照组，两组比较差异具有统计学意义（P＜0.05），术后6h，两组患者血清中的TNF-α、IL-6及IL-8水平明显升高，且观察组而术后24h，血清中的TNF-α、IL-6及IL-8水平又逐渐降低，观察组低于对照组，两组差异具有统计学意义（P＜0.05），观察组在手术时间、术中出血量、伤口长度、伤口长度、进食时间等基本指标方面都要少于对照组，其差异具有统计学意义（P＜0.05）。结论：腹腔镜治疗胃癌的临床疗效显著，术后炎症因子介质的释放有所减少，对机体免疫功能影响小，但对患者的凝血功能影响较大，治疗时应采取相应措施预防凝血功能异常导致的血栓。
• To investigate the clinical efficacy of laparoscopic gastric surgery. Methods: From July 2014 to June 2016 patients in our hospital ,87 cases of gastric cancer were selected as the study sample.The observation group which had 45 cases were treated with laparoscopic surgery, the control group which had 42 cases received conventional treatment of abdominal surgery.INR, APTT, PT, D-D, FIB and other coagulation factors were compared between two groups of patients before and after the surgery, the change of TNF-α, IL-6 and IL-8 were compared preoperative and postoperative 6h, 24h ,and determine the efficacy based on the basic situation of the two groups of patients. Results: Postoperative, INR, APTT and PT levels between the two groups were significantly lower, and the observation group was more than the control group, and two groups of patients after D-D and FIB were significantly increased, and the observation group higher in the control group, the difference was statistically significant (P <0.05), after 6h, two groups of patients serum TNF-α, IL-6 and IL-8 levels were significantly increased, and the observation group and postoperative 24h, serum TNF-α, IL-6 and IL-8 levels and decreased in the observation group than the control group, the difference was statistically significant (P <0.05), the observation group in operation time, blood loss the amount of the basic indicators, the length of the wound, the wound length of time should be eating less than the control group, the difference was statistically significant (P <0.05). Conclusion: The clinical efficacy of laparoscopic treatment of gastric cancer significantly, after the release of inflammatory cytokines media has decreased, little effect on immune function, but a greater impact on blood coagulation in patients, treatment should take appropriate measures to prevent coagulation abnormalities cause thrombus.