目的 探讨腹腔镜与内镜联合应用治疗胃肠道良性肿瘤的临床价值.方法 回顾性分析29例腹腔镜与内镜联合治疗胃肠道良性肿瘤中成功27例(观察组)的临床资料,同期35例开腹手术患者为对照组,比较两组手术出血量、术后肠道功能恢复时间、血清IL-6、IL-10、TNF-α、CRP水平变化等指标.结果 观察组未发生腹腔镜操作相关并发症,术中出血量约(59.35±16.30)ml,术后肠道功能恢复时间(2.08±0.45)d,禁食时间(3.17±0.57)d;对照组术中出血量约(135.70±25.10)ml,术后肠道功能恢复时间(3.64±1.43)d,禁食时间(5.60±1.79)d,P<0.05.观察组术后IL-6、TNF-α、CRP水平下降趋势较对照组出现早,幅度明显;而IL-10上升趋势较对照组出现的早和明显.结论 腹腔镜与内镜联合微创治疗胃肠道良性肿瘤手术具有对病变定位准确、创伤小、恢复快、降低患者全身炎症反应的优点,值得在临床上推广.%Objective To study the clinical value of endoscopy combined with laparoscopy in the treatment of benign gastrointestinal tumors, and to evaluate the efficacy and advantage of the surgery. Methods The data of 27 patients who successfully received operations performed by endoscopy combined with laparoscopy were retrospectively analyzed. At the same time the data of the control group( n = 35 )who underwent open surgery were collected. The clinical outcomes and indexes of two groups were observed and compared, including the level of IL - 6, IL - 10, TNF - a., CRP after operations. Results The observation group accomplished surgery successfully without intraoperative complications related to laparoscopy. Mean volume of blood loss was( 59. 35 ± 16. 30 )ml. Mean recovery time of gastrointestinal function was( 2. 08 ± 0. 45 )d,and fasting time was( 3. 17 ±0. 57 )d. In the control group,mean volume of blood loss was( 135.70 ± 25.10 )ml, mean recovery time of gastrointestinal function was( 3. 64 ± 1. 43 )d, and mean fasting time was ( 5. 60 ± 1.79 )d. The levels of IL - 6,TNF - a, CRP in serum in experimental groups were decreased ear-lier( P <0. 05 )and more significantly( P <0. 05 )than those in control group. The level of IL - 10 in serum in experimental groups increased more quickly and significantly than that in control group. Conclusion Benign gastroenteric tumors resection by endoscopy combined with laparoscopy demonstrates its advantages such as precise tumor localization,satisfying safety,minimal trauma,few complications and quick recovery, and its widespread use is recommended.
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