关键词: 胃肿瘤, 腹腔镜检查, 脑氧平衡

Abstract: Objective To compare and analyze the clinical effects of deep muscle relaxation and low intra-abdominal pressure versus deep muscle relaxation and high intra-abdominal pressure in laparoscopic radical gastrectomy. 
Methods A total of 96 patients undergoing laparoscopic radical gastrectomy admitted to our hospital were selected and divided into research group(47 cases, using deep muscle relaxation and low intra-abdominal pressure) and control group(47 cases, using deep muscle relaxation and high intra-abdominal pressure) according to the random number table method. The short-term clinical therapeutic effect, long-term clinical therapeutic effect, serum carcinoembryonic antigen(CEA), leptin(LEP), vascular endothelial growth factor(VEGF) level, degree of intestinal mucosal injury, intestinal function recovery, changes of cerebral oxygen balance index before anesthesia, before pneumoperitoneum and after anesthesia, and at 60 min after pneumoperit on eum establishment were analyzed. 
Results The short-term clinical therapeutic effect and long-term clinical therapeutic effect of the research group were significantly better than those in the control group(P＜0.05). After treatment, serum CEA and VEGF levels in the research group were lower than those in the control group, and serum LEP levels were higher than those in the control group(P＜0.05). The level of postoperative intestinal injury in the research group was lower than that in the control group(P＜0.05). The indicators of intestinal function recovery in the research group were shorter than those in the control group(P＜0.05). After the establishment of pneumoperitoneum, the values of the two groups all showed significant fluctuations. Compared with the research group, arterial partial pressure of carbon dioxide(PaCO2), cerebral blood flow/cerebral oxygen metabolic rate ratio(PjvO2), cerebral arteriovenous oxygen content difference(Ca-jvDO2), internal jugular vein oxygen content(CjVO2), jugular vein oxygen saturation(SjvO2) showed less fluctuations. There were significant difference in interaction between groups, time points and time points between groups(P＜0.05). 
Conclusion Compared with deep muscle relaxation and high intra-abdominal pressure, deep muscle relaxation and low intra-abdominal pressure is more effective in laparoscopic radical gastrectomy. It can effectively improve the patients' serum CEA, LEP, VEGF levels, reduce postoperative intestinal injury of patients, accelerate the intestinal function recovery, and stabilize cerebral oxygen balance of patients. Therefore, it is worthy of clinical application and popularization.

Key words: stomach neoplasms, laparoscopy, cerebral oxygen balance