高位胆管癌不同治疗方式的疗效评价  

Therapeutic effect evaluation on different treatments to Hilar cholangiocarcinoma

作　　者：陈卫东[1] 胡继雄[1] 苗雄鹰[1] 钟德午[1] 王群伟[1] 

机构地区：[1]中南大学湘雅二医院普通外科,湖南长沙410011

出　　处：《中国现代医学杂志》2008年第16期2380-2382,共3页China Journal of Modern Medicine

摘　　要：目的探讨高位胆管癌的有效治疗方法。方法回顾性分析2002年1月-2007年1月间该院收治的48例肝门部胆管癌的临床资料,对48例患者按不同的治疗方式分为根治性切除、根治性切除+肝动脉置管化疗、姑息性切除、胆肠内引流和外引流5组,分析各种治疗方式与生存时间和并发症的关系。结果全组手术切除率及手术并发症发生率为37.5%(18/48),围手术期手术死亡率为0.0%,术后平均生存期10.8个月,随访时间为0、4～5a不等,随访率为91.8%。切除组与引流组比较,在平均生存期、1、2和3年生存率等方面明显优于引流组(P<0.05),而两者并发症发生率则差异无显著性(P>0.05)。而根治性切除组的平均生存期、1、2和3年生存率又明显优于姑息性切除组(P<0.05)。结论肝门部胆管癌的治疗首选根治性切除,结合肝动脉置管化疗效果更好,姑息性切除的疗效优于各种内外引流术。[Objective] To study the effective therapeutic methods for the treatment of hilar bile duct cancer. [Methods] According to different therapeutic methods , 48 cases were put in 5 groups of radical resection , radical resection and TAE, local resection, cholangiojejuno Roux-en-Y anastomosis inner drainage and external drainage. The relations between different therapeutic procedures, survival time and complications were analysed.[Results] The survival time of radical resection group averages 22 months, radical resection and TAE group averages 30 months, local resection group 12 months, cholangiojejuno anastomosis group 8.4 months, and external drainage group 5.3 months. Total complications were 37.5 percent. Operation mortality was 0.0% percent. [Conclusion] Radical resection should be selected first for the treatment of hilar cholangiocarcinoma, while TAE can improve its therapeutic effect. The result of local resection is better than that of all kinds of inner or external drainage methods.

关 键 词：胆管肿瘤/外科手术 肝切除术 化疗 

分 类 号：R735.8[医药卫生—肿瘤]