进展期胃癌腹腔镜切除术后炎性反应和疼痛因子研究

Inflammatory response and pain factors after laparoscopic resection of advanced gastric cancer

摘要:

目的 探讨腹腔镜切除术对进展期胃癌患者术后炎性反应和疼痛因子的影响。方法 选择2019年3月－2021年3月该院进展期胃癌患者82例，依据随机数表法分为观察组（n = 41）和对照组（n = 41）。对照组实施开腹胃癌根治术，观察组实施腹腔镜下胃癌根治术。比较两组患者手术指标和术后并发症，观察术前、术后3和7 d血清炎性因子［肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和C反应蛋白（CRP）］和疼痛因子［去甲肾上腺素（NE）、P物质（SP）和5-羟色胺（5-HT）］的变化。结果 观察组手术时间长于对照组，而肛门排气时间、下床活动时间和住院时间均短于对照组，术中出血量少于对照组（P < 0.05）。观察组术后并发症发生率低于对照组（P < 0.05）。两组患者术后3和7 d血清TNF-α、IL-6和CRP水平较术前升高（P < 0.05），观察组术后3和7 d血清TNF-α、IL-6和CRP水平低于对照组（P < 0.05）。两组患者术后3和7 d血清NE、SP和5-HT水平较术前升高（P < 0.05），观察组术后3和7 d血清NE、SP和5-HT水平低于对照组（P < 0.05）。结论 腹腔镜下胃癌根治术治疗进展期胃癌，术后并发症发生率低，且对炎性反应和疼痛因子影响小，值得临床推广应用。

Abstract:

Objective To investigate the effect of laparoscopic resection on postoperative inflammatory response and pain factors for advanced gastric cancer.Methods 82 patients with advanced gastric cancer from March 2019 to March 2021 were selected divided into observation group (n = 41) and control group (n = 41) according to random number table method. Patients in the control group underwent open radical gastric cancer surgery, and patients in the observation group underwent laparoscopic radical gastric cancer surgery. The changes in surgical indicators and postoperative complications were compared between the two groups; Serum inflammatory factors [ tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) ] and pain factors [ norepinephrine (NE), substance P (SP) and 5-hydroxytryptamine (5-HT) ] changes of before operation, 3 and 7 d after operation.Results The operative time in observation group was longer than that in control group, while anal exhaust time, ambulation time and hospitalization time of the observation group were shorter than those of the control group, and the intraoperative blood loss was less than that of the control group (P < 0.05). The postoperative complications rate of observation group was lower than that in control group (P < 0.05). The serum TNF-α, IL-6 and CRP levels after postoperative 3 d and 7 d in two groups were higher than those before the operation (P < 0.05); The serum TNF-α, IL-6 and CRP levels in observation group were lower than those in control group (P < 0.05). The serum NE, SP and 5-HT levels after postoperative 3 d and 7 d in two groups were higher than those before the operation (P < 0.05); The serum NE, SP and 5-HT levels in observation group were lower than those of control group (P < 0.05).Conclusion Laparoscopic radical resection of gastric cancer for advanced gastric cancer has lower incidence of postoperative complications and little influence on inflammatory reactions and pain factors, which is worthy of clinical application.