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目的观察腹腔镜辅助下D2根治术治疗进展期胃癌的临床效果。方法选择2014年9月-2015年9月医院收治的进展期胃癌患者90例。随机分为对照组与观察组各45例。对照组采用开腹D2根治术治疗,观察组采用腹腔镜辅助D2根治术治疗。比较2组手术时间、术中出血量、术后疼痛、胃肠道恢复情况,术后住院时间等手术情况。随访观察患者术后并发症发生情况及2年生存情况。结果观察组术中出血量、术后止痛剂使用次数、胃肠道恢复时间、住院时间等手术指标均显著优于对照组,差异有统计学意义(P<0.05)。观察组术后生存质量评分显著高于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率显著低于对照组,观察组2年生存率显著高于对照组,差异有统计学意义(P<0.05)。结论进展期胃癌患者采用腹腔镜辅助D2根治术治疗,可显著改善患者术后生活质量及胃肠功能,对患者创伤小,术中出血量少,并发症少,生存率高,值得临床推广应用。
Objective To observe the clinical effect of laparoscopic-assisted D2 radical mastectomy for advanced gastric cancer. Methods From September 2014 to September 2015, 90 patients with advanced gastric cancer were admitted to the hospital. Randomly divided into control group and observation group of 45 cases. The control group was treated with laparotomy D2, and the observation group with D2 laparoscopic-assisted radical mastectomy. The operation time, intraoperative blood loss, postoperative pain, gastrointestinal tract recovery and postoperative hospital stay were compared between the two groups. Follow-up observation of patients with postoperative complications and 2-year survival. Results The intraoperative blood loss, the number of analgesics used, the recovery time of gastrointestinal tract and the length of hospital stay in the observation group were significantly better than those in the control group. The difference was statistically significant (P <0.05). The postoperative quality of life score of the observation group was significantly higher than that of the control group, with significant difference (P <0.05). The incidence of complications in the observation group was significantly lower than that in the control group. The 2-year survival rate in the observation group was significantly higher than that in the control group (P <0.05). Conclusions Laparoscopic assisted D2 radical mastectomy can significantly improve the postoperative quality of life and gastrointestinal function in patients with advanced gastric cancer. It has less trauma, less intraoperative blood loss, less complications and high survival rate, which is worthy of clinical application .