食管癌食管支架置入术患者的预后及影响因素分析  

Prognosis of patients with esophageal neoplasms after undergoing esophageal stenting surgery and its influencing factor

作　　者：陈理明[1] 钟敏[2] 李悦虹[2] 王仕莲[2] 谢晓原[1] 李晓洁[1] 

机构地区：[1]汕头大学医学院第一附属医院肿瘤科,广东汕头515041 [2]汕头大学医学院第一附属医院内镜中心,广东汕头515041

出　　处：《海南医学院学报》2012年第6期808-811,共4页Journal of Hainan Medical University

基　　金：中国高校医学期刊临床专项资金项目(112210194)~~

摘　　要：目的:探讨食管支架置入术(esophageal stenting)治疗恶性食管狭窄的预后及其影响因素。方法:对2004～2009年行食管支架置入术的91例食管癌患者进行随访,随访时间1～60个月,随访率为95.6%。分析8项可能影响生存率的因素,探讨其与生存率的相关性。生存率影响因素的单因素分析采用Kaplan-Meier模型及Log-rank检验,多因素分析采用COX比例风险模型。结果:全组患者置入食管支架后的半年、1年、3年和5年生存率分别是55.9%、27.8%、14.9%和8.6%,中位生存期为8.1个月。可能影响生存率的8项单因素中,3项有统计学意义,分别为肿瘤UICC分期、根治性手术史和是否合并食管瘘(均P<0.05)。与生存率相关的多因素有3项,分别为肿瘤UICC分期、根治性手术史和是否合并食管瘘(均P<0.05)。结论:食管支架置入术治疗恶性食管狭窄的短期疗效好,但中长期疗效较差。其预后影响因素为肿瘤UICC分期、根治性手术史和是否合并食管瘘,此结果有助于指导食管支架置入术在食管癌综合治疗中的应用。Objective： To explore the prognosis of patients with esophageal neoplasms after undergoing esophageal stenting surgery and its influencing factors.Methods： A total of 91 patients with malignant esophageal stenosis underwent esophageal stenting from 2004 to 2009 were enrolled.The follow-up lasted for 1 to 60 months and the follow-up rate was 95.6%.Eight possible risk factors affecting survival rate were analyzed,and the relationship between these factors and survival rate was also analyzed.Univariate analysis of risk factors was analyzed by Kaplan-Meier model and Log-rank test and multivariate analysis was analyzed by COX regression model.Results： The survival rate at half a year,1 year,3 year and 5 year was 55.9%,27.8%,14.9% and 8.6%,respectively.Medial survival time was 8.1 months.Three of eight possible risk factors were found significant,including UICC stage,history of radical resection and esophageal fistula（All P0.05）.Conclusions： Esophageal stenting is effective in short term on the treatment of malignant esophageal stenosis,but it is poor in mid-long term outcome.UICC stage,history of radical resection and esophageal fistula are risk factors.This study is useful in the synthetic treatment of esophageal neoplasms.

关 键 词：支架置入术 食管肿瘤 预后 

分 类 号：R735.1[医药卫生—肿瘤]