開(kāi)腹與腹腔鏡手術(shù)對(duì)胃癌患者營(yíng)養(yǎng)狀況的影響分析

[摘要] 目的 研究探討開(kāi)服和腹腔鏡兩種手術(shù)方式對(duì)胃癌患者營(yíng)養(yǎng)狀況的影響狀況。方法 方便選取2012年7月—2016年2月在該院接受治療的250例胃癌患者為治療對(duì)象，按照隨機(jī)數(shù)字表將其均分為兩組每組125例，對(duì)照組患者接受開(kāi)腹治療，治療組患者接受腹腔鏡治療，觀察記錄所有患者治療前后的生理指標(biāo)數(shù)值、并發(fā)癥情況、生活質(zhì)量評(píng)分和營(yíng)養(yǎng)狀況合格率等四項(xiàng)指標(biāo)。結(jié)果 經(jīng)對(duì)數(shù)據(jù)統(tǒng)計(jì)分析可知，治療組患者的血清白蛋白和血清前白蛋白數(shù)據(jù)即（189.43±26.40）mg/L和（40.86±3.54）g/L明顯高于對(duì)照組患者的數(shù)據(jù)即（176.18±20.37）mg/L和（34.69±2.57）g/L，其并發(fā)癥數(shù)據(jù)明顯優(yōu)于對(duì)照組患者，其在術(shù)后的睡眠、精神、日常生活、疲乏水平的評(píng)分?jǐn)?shù)據(jù)即（70.34±10.93）分、（66.72±11.94）分、（71.59±19.68）分和（65.82±15.97）分明顯高于對(duì)照組患者的評(píng)分?jǐn)?shù)據(jù)即（46.80±11.48）分、（43.65±12.75）分、（53.88±18.37）分和（43.67±16.43）分，其營(yíng)養(yǎng)合格率即90.40%同樣明顯高于對(duì)照組即74.40%，上述數(shù)據(jù)間差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 腹腔鏡手術(shù)療法相比開(kāi)腹手術(shù)更能改善患者術(shù)后營(yíng)養(yǎng)狀況，降低不良反應(yīng)發(fā)生率，具有較高的臨床推廣價(jià)值。

[關(guān)鍵詞] 開(kāi)腹；腹腔鏡；胃癌；營(yíng)養(yǎng)狀況

[中圖分類(lèi)號(hào)] R735.2 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-0742（2016）11（a）-0083-03

[Abstract] Objective To explore the influence condition of nutritional status on gastric cancer patients by means of laparotomy and laparoscopic surgery. Methods Convenient selection two hundred and fifty patients with gastric cancer who received treatment in our hospital from July 2012 to February 2016 were regarded as treatment objects， and they were evenly divided into two groups according random number table （125 patients in each group）. The control group were cured by laparotomy surgery and the treatment group were cured by laparoscopic surgery. We should observe and record all those patients’four indexes before and after treatment including physiological indexes， complications， the score of life quality and the qualification rate of nutritional status. Results Through statistical analysis of experimental data， the treatment group with the data of serum albumin and pre-albumin （189.43±26.40）mg/L and （40.86±3.54）g/L were higher than the data of control group （176.18±20.37）mg/L and （34.69±2.57）g/L obviously， and its complication data was much better than the control group， besides its rating data about sleep， spirit， daily life and fatigue level post operation （70.34±10.93）points， （66.72±11.94）points， （71.59±19.68）points and （65.82±15.97）points were higher than the data of control group （46.80±11.48）points， （43.65±12.75）points， （53.88±18.37）points and （43.67±16.43）points obviously， finally its nutritional pass rate were also higher than the pass rate of control group obviously （90.40% vs 74.40%）. The differences of all the corresponding data were significant （P<0.05）. Conclusion Compared with the laparotomy surgery， the laparoscopic surgery could improve the nutritional status of patients post operation and reduce the incidence of adverse reactions， so it has clinical spread value.

[Key words] Laparotomy； Laparoscopic； Gastric cancer； Nutritional status

作為一種常見(jiàn)的消化道疾病，胃癌對(duì)患者的生命健康和生活質(zhì)量具有顯著的惡劣影響，以至于大多數(shù)患者都并發(fā)營(yíng)養(yǎng)不良等癥狀，逐漸可形成惡性腫瘤和營(yíng)養(yǎng)不良的惡性循環(huán)，導(dǎo)致一系列包括消瘦、消化道出血等在內(nèi)的臨床癥狀[1]，但從臨床實(shí)踐來(lái)看，對(duì)于該病進(jìn)行早期治療大多能取得較好的預(yù)后效果。目前臨床上對(duì)于該病的治療，傳統(tǒng)的開(kāi)腹手術(shù)和腹腔鏡手術(shù)都能起到良好的臨床療效，但由于病灶位于患者的胃部消化系統(tǒng)，在此進(jìn)行手術(shù)難免會(huì)對(duì)其造成一定傷害，從而對(duì)患者術(shù)后胃部造成難以忽視的影響[2]?！?br>