无结扎技术与传统技术在胃癌根治术中的近期疗效比较

摘要

目的：探讨无结扎外科技术在胃癌根治术中的临床价值和疗效。方法选择2011年1月~2013年12月广西壮族自治区人民医院行胃癌根治术病例60例,按照手术方式分为无结扎组和传统组,每组各30例。观察两组患者围术期临床疗效和外周血免疫功能变化。结果全部两组病例手术顺利,无术中、术后大出血。无结扎组与传统组手术时间分别为(82.67±17.05)、(93.80±14.55) min,术中出血量分别为(65.50±24.05)、(93.50±35.51)mL,术后平均引流量分别为(136.17±66.13)、(228.77±101.63)mL,两组比较差异均有统计学意义(P<0.05)；无结扎组与传统组清扫淋巴结个数分别为(19.16±9.12)、(20.13±7.43)个,平均肛门排气时间分别为(3.90±0.68)、(4.00±0.73)d,术后住院时间分别为(10.87±1.33)、(11.40±1.87)d,两组比较差异均无统计学意义(P>0.05)。术后第1天、术后第7天无结扎组患者血球蛋白水平[(23.88±3.63)、(28.82±4.44)g/L]较传统组[(21.84±3.96)、(25.44±4.23)g/L]显著升高,差异均有统计学意义(P<0.05)。术前、术后第1天、术后第7天两组外周血血红蛋白、红细胞比积、淋巴细胞计数、总蛋白、白蛋白及淋巴细胞计数比较,差异均无统计学意义(P>0.05)。结论无结扎外科技术实施胃癌根治术可避免血管夹、缝线等异物体内存留,与传统胃癌根治术比较可达到相同的肿瘤根治效果,但具有手术时间短、术中出血及术后引流量少、手术创伤小、免疫功能损伤小的优点。%Objective To investigate the clinical value and efficacy of radical gastrectomy of no-ligation surgical techniques in patients with gastric cancer. Methods 60 cases of patients from January 2011 to December 2013 in the People's Hospital of Guangxi Zhuang Autonomous Region were selected, all patients were given the radical gastrectomy, which were diveded into no-ligation technology group and traditional technology group according to operative method, 30 patients in each group. Postoperative clinical efficacy and immune functional changes in peripheral blood of two groups were observed. Results All the patients were operated successfully, and no intranperative or postoperative massive hemorrhage occurred. In no-ligation technology group and traditional technology group, the operative time were (82.67±17.05), (93.80±14.55) min respectively, the blood loss of operation were (65.50±24.05), (93.50±35.51) mL respectively, and the average volume of drainage were (136.17±66.13), (228.77±101.63) mL respectively, the differences between the two groups were statistically significant (P< 0.05); the number of lymph node dissection were (19.16±9.12), (20.13±7.43) respectively, the average anal exhaust time were (3.90±0.68), (4.00±0.73) d respectively, and postoperative hospital stay were (10.87±1.33), (11.40±1.87) d respectively, there was no statistically significant difference hematocrit, lymphocyte count, total protein, albumin and lymphocyte counts in the two groups was no statistically significant difference (P> 0.05). Conclusion No-ligation surgical technology implemented radical gastrectomy to avoid vascular clips, sutures and other foreign matter in v iv o retention. Comparing with the traditional radical gastrectomy, no-ligation surgical technology can achieve the same effect of tumor cure, and good advantages with shorter operative time, less blood loss and postoperative drainage, less surgery trauma, less damage to the immune function.