腹腔镜—内镜系统联合根治术治疗早期胃癌老年患者的效果评估 ^*

Evaluation of laparoscopic-endoscopic system combined with radical surgery in the treatment of elderly patients with early gastric cancer

摘要

目的 探究腹腔镜—内镜系统联合根治术治疗早期胃癌老年患者的近远期疗效及对胃泌素和营养水平的影响。方法 选取2012年1月—2022年12月新疆医科大学第一附属医院收治的100例早期胃癌老年患者作为研究对象, 将其随机分为研究组和对照组, 各50例。对照组给予开腹手术, 研究组予以腹腔镜—内镜系统联合根治术。比较两组的近期疗效、远期疗效, 胃泌素、营养水平和术后并发症的情况。结果 与对照组比较, 研究组的手术时间更长, 术中出血量更少, 术后首次排气时间、下床时间、住院时间更短 (P<0.05)。两组的复发率、黏膜层生存率、黏膜下层生存率、总体生存率比较, 差异均无统计学意义 (P>0.05)。与对照组比较, 研究组术后胃泌素、胃动素水平更高, 胆囊收缩素水平更低, 白蛋白、前白蛋白、血红蛋白水平更高 (P<0.05), 对照组与术前比较差异均有统计学意义 (P<0.05)。研究组并发症总发生率更低 (P<0.05)。结论 腹腔镜—内镜系统联合根治术可显著改善早期胃癌老年患者的近期疗效, 对胃泌素的分泌和机体的营养水平影响更小, 且术后并发症更少。

Abstract

Objective To investigate the short-term and long-term curative efficacy of laparoscopic endoscopic system combined with radical surgery in the treatment of elderly patients with early gastric cancer and its effect on gastrin and nutritional levels. Methods A total of 100 elderly patients with early gastric cancer admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2012 to December 2022 were selected as the study subjects and randomly divided into the study group and the control group, with 50 cases in each group. The control group was given laparotomy, and the study group was given laparoscopic endoscopic system combined with radical surgery. The short-term curative efficacy, long-term curative efficacy, gastrin, nutritional level and postoperative complications were compared between the two groups. Results Compared with the control group, the study group had longer operation time, less intraoperative blood loss, and shorter postoperative first exhaust time, time to get out of bed, and hospital stay (P<0.05). There were no significant differences in the recurrence rate, mucosal survival rate, submucosal survival rate, and overall survival rate between the two groups (P>0.05). Compared with the control group, the study group had higher postoperative GAS and MTL levels and lower CCK levels (P<0.05); ALB, PAB, and HB levels (P<0.05); the control group had significant differences from the preoperative group (P<0.05). Overall complication rate was lower (P<0.05). Conclusion Laparoscopic-endoscopic system combined with radical surgery can significantly improve the short-term efficacy of elderly patients with early gastric cancer, with less effect on gastrin secretion and nutritional level of the body, and fewer postoperative complications.

关键词

腹腔镜—内镜系统联合根治术 / 早期胃癌 / 近期疗效 / 远期疗效 / 胃泌素 / 营养水平

Key words

Laparoscopic-endoscopic system combined with radical surgery / Early gastric cancer / Short-term curative effect / Long-term curative effect / Gastrin / Nutritional level

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基金资助

^*新疆维吾尔自治区自然科学基金(2023D01C99)