全胃切除与近侧胃切除治疗胃底贲门部癌术后生存状态对比分析  

Comparative Analysis on Survival Condition after Total Gastrectomy and Proximal Gastrectomy for Gastric Cardia Cancer

作　　者：王云[1] 蒲长春[1] 吴敬章[1] 陈岩[1] 

机构地区：[1]甘肃省白银市第一人民医院普通外科(兰州大学附属白银医院普通外科),甘肃白银730900

出　　处：《中国普外基础与临床杂志》2013年第11期1272-1278,共7页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的研究全胃切除术治疗胃底贲门部癌在术后生存状况方面的意义。方法回顾性分析1997年5月至2012年10月期间兰州大学附属白银医院普通外科手术治疗的118例胃底贲门部癌患者的临床资料,其中行全胃切除术(全胃切除组)65例,行近侧胃切除术(近侧胃切除组)53例;对比分析2组患者的术后并发症、生存率、生活质量、营养指标等相关资料。结果①术后并发症发生率全胃切除组为7.7%(5/65),近侧胃切除组为13.2%(7/53),2组术后主要并发症发生率比较差异无统计学意义(χ2=0.972,P=0.248)。②术后1、3、5年生存率全胃切除组分别为63.1%、46.2%及30.8%,近侧胃切除组分别为66.0%、36.9%及18.5%,2组1年生存率比较差异无统计学意义(χ2=0.193,P=0.402),全胃切除组的3、5年生存率明显高于近侧胃切除组(χ2=4.508,P=0.022;χ2=30.271,P=0.000)。③Spitzer生活质量评分在术后不同时相全胃切除组和近侧胃切除组间比较差异均无统计学意义(P>0.05)。术后不同时相Chew-wun Wu特殊症状量表评分:术后3个月时,全胃切除组烧心感的评分明显高于近侧胃切除组(P<0.05);术后6个月时,全胃切除组的烧心感和吞咽困难的评分均明显高于近侧胃切除组(P<0.05);术后12个月时,食欲、进食量、烧心感和吞咽困难的评分均明显高于近侧胃切除组(P<0.05);其余指标2组间比较差异均无统计学意义(P>0.05)。④全胃切除组和近侧胃切除组术后营养指标比较差异均无统计学意义(P>0.05)。结论从本组资料看,全胃切除术治疗胃底贲门部癌,不增加并发症发生率,并能提高患者长期生存率,术后患者总体生存质量优于近侧胃切除术。Objective To study the clinical significance of total gastrectomy in treatment for gastric cardia cancer. Methods The clinical data of 118 patients with gastric cardia cancer underwent operation from May 1997 to October 2012 in the Department of General Surgery of Baiyin Hospital, Affiliated to Lanzhou University were analyzed retrospectively. Among these 118 patients, there were 65 patients treated by total gastrectomy （total gastrectomy group） and 53 patients treated by proximal gastrectomy （proximal gastrectomy group）. The postoperative complications, survival rate, quality of life, and nutrition indexes were compared after operation between the total gastrectomy group and the proximal gastrectomy group. Results ① The incidence of postoperative complications was 7.7% （5/65） and 13.2% （7/53） in the total gastrectomy group and the proximal gastrectomy group, respectively, the difference was not statistically significant （X22=0. 972, P=0. 248）. ② 1-, 3-, and 5-year survival rate after operation were 63.1%, 46. 2%, and 30. 8% in the total gastrectomy group; which were 66.0%, 36. 9%, and 18.5% in the proximal gastrectomy group. The difference of 1-year survival rate after operation was not statistically significant in two groups （X22=0. 193, P=0. 402）, the 3- and the 5-year survival rates of the total gastrectong group were significantly higher than those of the proximal gastrectony group （X2=4. 508, P=0. 022;X2=30. 271, P=0. 000）. ③ The Spitzer quality of life score had no difference at the different time after operation in two groups （/9〉0. 05）. Compared with the proximal gastrectomy group, the points of heartbum, swallowing problem, appetite, and food intake on 12 months after operation in the total gastrectomy group were higher （P〈 0. 05）, the points of the other indexes had no significant differences （P〉0. 05）. ④ The nutrition indexes after operation had no differences at the different time after operation in two groups （P〉 0. 05）. Conclusions Total g

关 键 词：胃底贲门部癌 胃切除术 生存状态 

分 类 号：R735.2[医药卫生—肿瘤]