壶腹癌的外科治疗与预后分析  

Surgical Treatment of Ampullary Carcinoma and Prognostic Analysis

作　　者：郑云[1] 卢洪军[2] 张大鹏[1] 

机构地区：[1]天津市南开医院外二科,天津300100 [2]天津医科大学研究生院,天津300070

出　　处：《中国中西医结合外科杂志》2013年第5期499-502,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:评价不同手术方式对壶腹癌的治疗效果,并分析其与预后的关系。方法:回顾性研究81例壶腹癌患者的临床资料,根据治疗方法不同,50例采用肿瘤切除术治疗,31例采用姑息性手术治疗。分析不同治疗方法的术后并发症发生情况及预后。结果:肿瘤切除患者的术后并发症发生率差异有统计学意义(P<0.05),肿瘤局部切除患者的术后并发症发生率比行胰十二指肠切除术低。行不同方法的姑息性手术患者,术后并发症的发生率差异无统计学意义(P>0.05)。采用肿瘤切除治疗后,患者的生存时间差异无统计学意义(P=0.475),但采用不同方法的姑息性术式治疗后,患者的生存时间差异有统计学意义(P<0.001)。研究发现,壶腹癌行肿瘤切除术后的中位生存时间比行姑息性手术长。姑息性手术方式中,行ERBD术后的中位生存时间比胆肠吻合和经皮经肝胆道穿刺引流治疗的长。结论:壶腹癌行根治性胰十二指肠切除术后并发症发生率相对较高,但术后生存时间长。Objective To investigate the therapeutic effects of patients with carcinoma of ampulla treated by different surgical methods, and to analyze the relationship with the prognosis. Methods Clinical data of 81 cases of ampullary carcinoma were retrospectivly studied, according to different therapeutic methods, 50 cases treated with tumor resection, 31 cases with palliative surgery. The postoperative complications and prognosis of different therapies were analyzed. Results The incidence of postoperative complications with tumor resection patients was statistically significant （P 〈 0.05）,the incidence of postoperative complications with local tumor re section patients was lower than that of panereaticoduodenal resection. The incidence of postoperative complica tions was with no statistically significant difference （P 〉 0.05）. The survival time of patients with tumor resection was not statistically significant （P = 0.475）,and that with palliative surgery treatment was statistically significant （P 〈 0.001）.The study showed that the median survival time with ampulla carcinoma tumor resection treatment was longer than that with palliative surgery treatment. The median survival time of palliative surgery patients with ERBD treatment was longer than with bravery intestinal anastomosis and pereutaneous transhepatie cholan gial drainage. Conclusion The incidence of postoperative complications of ampulla carcinoma patients with radical resection of pancreas and duodenum was relatively high, and the postoperative survival time was compara tively long.

关 键 词：壶腹癌 外科治疗 预后 

分 类 号：R735[医药卫生—肿瘤]