中文摘要：

目的比较常规开腹手术与腹腔镜辅助下治疗胃癌的近期效果。方法选取2013年10月至2015年9月收治的胃癌患者86例,随机分为腹腔镜辅助组38例,常规开腹组48例。腹腔镜辅助组采用腹腔镜系统辅助完成胃癌切除以及消化道重建,常规开腹组采用常规开腹手术进行胃癌根治术。观察比较两组手术相关指标及对免疫功能、炎症因子和凝血功能的影响,以及近期并发症发生情况。结果腹腔镜组平均术中出血量、术后胃肠功能恢复时间、术后住院时间优于常规开腹组（P均〈0.01）;但手术时间长于常规开腹组（P〈0.05）。两组淋巴结清扫数量分别为（21.89±5.67）、（23.19±4.33）枚,差异无统计学意义（P〉0.05）。两组术后CD3、CD4、CD8和CD4/CD8较术前均明显降低（P均〈0.05）,但腹腔镜组术后4项指标均高于常规开腹组术后（P均〈0.05）。两组术后CRP和IL-6水平均明显增加,与术前比较差异均有统计学意义（P均〈0.05）,但腹腔镜组术后2项指标均低于常规开腹组（P均〈0.05）。与术前相比,两组患者术后凝血酶时间（TT）均明显降低,纤维蛋白原（FIB）、D-二聚体（D-D）水平明显升高（P均〈0.05）,但腹腔镜组患者术后TT低于常规开腹组术后,FIB、D-D水平高于常规开腹组术后（P均〈0.05）。腹腔镜组、开腹组患者术后总并发症发生率分别为18.42%、20.83%,差异无统计学意义（P〉0.05）,但腹腔镜组下肢静脉血栓发生率高于开腹组,差异有统计学意义（P〈0.05）。结论腹腔镜辅助胃癌治疗,可明显减少手术创伤,对免疫功能影响较小,加速患者术后康复,但应注意提高手术操作技巧,加强对下肢静脉脉血栓的预防。

英文摘要：

Objective To compare the short-term efficacy of conventional laparotomy and laparoscopy-assisted approach for the treatment of gastric cancer. Methods Eighty-six patients with gastric cancer from October 2013 to September 2015 were randomly divided into laparoscopy-assisted surgery group（ 38 cases） and conventional laparotomy group（ 48 cases）.Gastric cancer resection and digestive tract reconstruction were completed by the assistant of laparoscopic system in laparoscopy-assisted surgery group,and the radical surgery of gastric cancer was performed by conventional laparotomy in conventional laparotomy group. The surgery-relative indices,immunologic function,inflammatory factors and coagulation function were compared between two groups. Results The volume of intraoperative blood loss,the postoperative recovery of gastrointestinal tract function and the postoperative length of hospital stay in laparoscopy-assisted surgery group were all significantly lower than those in conventional laparotomy group（ all P〈0. 05）,while the operation time in laparoscopy-assisted surgery group was significantly longer than that in conventional laparotomy group（ P〈0. 05）. There was no significant difference in the number of cleaned lymph nodes between two groups [（ 21. 89 ± 5. 67） vs（ 23. 19 ± 4. 33）,P〈0. 05].Compared with pre-operation,the levels of CD3,CD4,CD8 and CD4 / CD8 in both two groups decreased significantly after operation（ all P〈0. 05）,but they were higher in laparoscopy-assisted surgery group than those in conventional laparotomy group after operation（ all P〈0. 05）. Compared with pre-operation,the levels of CRP and IL-6 in both two groups increased significantly after operation（ all P〈0. 05）,but they were lower in laparoscopy-assisted surgery group than those in conventional laparotomy group after operation（ all P〈0. 05）. Compared with pre-operation,the levels of thrombin time（ TT） decreased significantly,and the levels of fibrinogen（ FIB） and d-dimer（ D-D?