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目的探讨医用生物胶在减少胃癌淋巴结廓清术后腹腔渗液的临床价值。方法2002年6月至2003年12月间,采用信封法将70例胃癌D2及D2+术患者随机分成医用胶组(A组,35例)和对照组(B组,35例)。A组在完成胃癌切除、胃周淋巴结廓清后于后腹膜淋巴结清扫区域滴注医用生物胶;B组则不用。观察术后1～5d腹腔引流液量、蛋白定量、红细胞数(RBC)、血红蛋白(Hb)量。结果全组无手术死亡。A组术后1～3d腹腔引流液量和蛋白丢失量明显少于B组(P<0.01);4～5d时两组相仿(P>0.05);但前5d总的腹腔引流液量和蛋白丢失量A组均少于B组(P<0.01)。两组腹腔引流液中RBC和Hb均以术后第1天为高峰,其后逐渐减少,两组比较差异无统计学意义(P>0.05)。结论医用胶可有效减少胃癌淋巴结廓清术后的腹腔渗出,有助于术后的恢复。
Objective To investigate the clinical value of medical biological glue in reducing abdominal fluid leakage after lymph node dissection. Methods From June 2002 to December 2003, 70 patients with gastric cancer D2 and D2+ were randomly divided into a medical gel group (A group, 35 cases) and a control group (B group, 35 cases) by the envelope method. In group A, after the removal of gastric cancer and the clearance of lymph nodes around the stomach, the biological glue was instilled in the area of retroperitoneal lymph node dissection. Observed the amount of intraperitoneal drainage fluid, protein, red blood cell (RBC), hemoglobin (Hb) volume from 1 to 5 days after operation. Results No operative death occurred in the whole group. In group A, peritoneal drainage volume and protein loss were significantly less than those in group B (P<0.01) from 1 to 3 days after operation; the two groups were similar at 4 to 5 days (P>0.05); however, the total peritoneal drainage volume and protein in the first 5 days. Loss volume in group A was less than in group B (P<0.01). The RBC and Hb levels in the peritoneal drainage fluids of both groups peaked on the first postoperative day and then decreased gradually. There was no significant difference between the two groups (P>0.05). Conclusion The medical adhesive can effectively reduce the peritoneal exudation after lymph node dissection of gastric cancer, and it is helpful for the recovery after operation.