3.3 æé«˜èƒƒç™Œåˆ†æœŸçš„准确性,æ£ç¡®è¯„估胃癌预åŽå’ŒæŒ‡å¯¼æœ¯åŽè¾…助治疗。而胃癌å‰å“¨æ·‹å·´ç»“æ£€æµ‹çš„ç›®æ ‡ç›´æŽ¥æŒ‡å‘æœ€å¯èƒ½å‘生转移的SLN,å¯åæ˜ æ•´ä¸ªåŒºåŸŸæ·‹å·´ç»“çš„è½¬ç§»çŠ¶æ€ï¼Œä¸ä½†å¾®åˆ›ç®€å•,而且准确å¯é ,ä¸å®¹æ˜“é—æ¼ï¼Œå°¤å…¶å¯¹æé«˜ç—…ç†åˆ†æœŸå‡†ç¡®æ€§ï¼Œæ£ç¡®è¯„估其预åŽï¼Œç¡®å®šæœ¯åŽè¾…助化疗具有é‡è¦ä¸´åºŠæ„义。
3.4 促进胃癌微创外科的å‘å±•ã€‚ä¼ ç»Ÿæ‰‹æœ¯è¦ç•™ä¸‹15厘米左å³çš„刀å£ï¼Œè€Œé‡‡ç”¨è…¹è…”镜胃癌微创手术,则åªéœ€åœ¨ç—…人腹部打5个直径约1厘米的å°å”,以供光æºã€æ“作刀的进入。术åŽï¼Œç—…人疼痛大大å‡è½»ï¼Œèº«ä½“æ¢å¤æ›´å¿«ã€‚æ¤å¤–,采用腹腔镜胃癌微创手术,还有以下优点:å‡å°‘肿瘤的扩散,å‡å°‘è‚ ç²˜è¿žç‰æœ¯åŽå¹¶å‘症,å‡å°‘手术ä¸å‡ºè¡€é£Žé™©ç‰ã€‚腹腔镜胃癌手术尤其适åˆå¹´çºªè¾ƒå¤§ã€èº«ä½“虚弱的病人。
腹腔镜微创手术的å¦ä¸€ä¸ªé‡å¤§åŠŸæ•ˆï¼šåœ¨æ²¡æœ‰è…¹è…”é•œä¹‹å‰ï¼Œå¯¹äºŽå¼€åˆ€åŽå‘现的晚期肿瘤,医生多åŠé€‰æ‹©æ”¾å¼ƒæ‰‹æœ¯ï¼Œè¿™ä¸ä»…ä½¿ç—…äººèº«ä½“å—æŸï¼Œè¿˜å¢žå¤§äº†è‚¿ç˜¤æ„ŸæŸ“ã€æ‰©æ•£çš„风险。而有了腹腔镜以åŽï¼Œåªéœ€åœ¨ç—…人腹部打一个å”进行探查,看是å¦èƒ½å¤Ÿè¿›è¡Œæ‰‹æœ¯æ²»ç–—ã€‚è¿™æ ·ä¸€æ¥ï¼Œä¸éœ€å¼€åˆ€ï¼Œç—…人身体ä¸å—æŸä¼¤ï¼ŒåŒ»ç”Ÿè¿˜å¯ä»¥é€šè¿‡æ¤å”注入肿瘤化疗è¯ç‰©ã€‚对于病ç†ä¸æ˜Žçš„æ‰‹æœ¯ï¼Œè¿˜å¯ä»¥åˆ©ç”¨è…¹è…”镜å–ç»„ç»‡åšæ´»æ£€ã€‚
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由于胃部血管丰富ã€è§£å‰–层é¢å¤šã€æ·‹å·´ç»“清扫难度大ã€å»åˆå¤æ‚ç‰å› ç´ ï¼Œè…¹è…”é•œèƒƒç™Œå¾®åˆ›æ‰‹æœ¯éš¾åº¦å¤§ï¼ŒæŠ€æœ¯è¦æ±‚高。å¯ä»¥è¯´ï¼Œè…¹è…”镜胃癌微创手术代表了医院外科医疗技术的精湛水平。
éœ€è¦æé†’çš„æ˜¯ï¼Œä½œä¸ºä¸€ç§æ²»ç–—手段,腹腔镜微创手术并ä¸é€‚åˆæ‰€æœ‰èƒƒç™Œçš„æ²»ç–—。å—医疗器械本身的é™åˆ¶ï¼Œè…¹è…”é•œå¯¹æ—©æœŸèƒƒéƒ¨è‚¿ç˜¤æœ‰ç€æ˜¾è‘—的治疗效果,倘若肿瘤过大,还是需è¦åšå¼€åˆ€æ‰‹æœ¯çš„。
å‚考文献
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