血小板计数升高对结直肠癌患者术后近远期疗效的影响  

Effect of High Platelet Count on Short- and Long-Term Outcomes for Patient with Colorectal Cancer Following Operation

作　　者：阳川华[1,2] 周晓爽[1,2] 赵芹[1,2] 魏梦欢 甘志明[1,2] 汪晓东[1] 李立[1] 

机构地区：[1]四川大学华西医院胃肠外科中心,四川成都610041 [2]四川大学华西临床医学院MCQ团队,四川成都610041

出　　处：《中国普外基础与临床杂志》2014年第8期980-984,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨血小板计数升高对结直肠癌患者术后近、远期疗效的影响。方法本研究回顾性纳入2009年1～10月期间在四川大学华西医院胃肠外科中心结直肠外科专业组进行手术治疗并符合本研究条件的结直肠癌患者共398例。根据术前血小板计数分组,血小板计数（100～300）×109/L者为正常血小板组,血小板计数高于300×109/L者为高血小板组,分析比较2组的近、远期疗效。结果 1 2组患者在性别、年龄、组织学类型、分化程度、肿瘤直径、肿瘤部位及手术方式方面差异均无统计学意义（P〉0.05）,但高血小板组TNM分期Ⅲ、Ⅳ期肿瘤比例明显高于正常血小板组（P=0.034）。2正常血小板组的首次排气和排便时间均要明显早于高血小板组（P〈0.05）,2组在首次进食、拔引流管、拔尿管、拔胃管、下床活动及住院时间方面比较差异均无统计学意义（P〉0.05）。3 2组术后总并发症发生率比较差异无统计学意义（P〉0.05）,2组单独并发症发生率比较差异也均无统计学意义（P〉0.05）。4 398例患者均获随访,平均随访58个月。随访期间有7例患者出现复发,高血小板组的复发率明显高于正常血小板组（3.5%比1.0%,P=0.013）;有35例患者死亡,高血小板组的死亡率明显高于正常血小板组（15.7%比6.0%,P=0.002）。结论血小板计数与结直肠癌恶性程度有关,血小板计数高的结直肠癌患者术后胃肠道功能恢复延缓,且术后复发率及死亡率更高。Objective To study the short- and long-term outcomes of high platelet count in patients with colorectal cancer after surgery. Methods A total of 398 patients with colorectal cancer who complied with the requirements for this study and operated in professional group on colorectal surgery of Gastrointestinal Surgery Center of West China Hospital in Sichuan University from January 2009 to October 2009 were retrospectively included in this study. Based on the last preoperative platelet count, these patients were divided into normal platelet group （100×109/L-300×109/L） and high platelet group （〉 300 × 109/L）. The short- and long-term outcomes were analyzed and compared between two groups. Results （1） The gender, age, histological type, degree of differentiation, diameter of tumor, site of tumor, and operation method had no significant differences between two groups （P〉0. 05）, but the ratio of Ⅲ, Ⅳ stages of TNM in the high platelet group was significantly higher than that in the normal platelet group （P〈0. 05）. （2） The first exhaust time and defecation time of the normal platelet group was significantly shorter than those of the high platelet group （P〈0. 05）. The time of the first oral intake, the time of pull out the drainage, ureter, and nasogastric tube, the time of the first ambulation, and hospitalstay had no significant differences between two groups （P 〉 0. 05）. （3） The total complications rate and single complication rate had no significant differences between two groups （P 〉 0. 05）. （4） All the patients were followed-up with average following-up time 58 months, there were 7 patients with recurrence and 35 patients with death in all the followed-up patients, the recurrence rate and death rate in the high platelet group were significantly higher than those in the normal platelet group （3.5% versus 1.1%, P=-0. 013; 15.7% versus 6. 0%, P=0. 002）. Conclusions There is a relationship of platelet count to colorectal malignant degree. The recovery tim

关 键 词：血小板计数 结直肠癌 预后 

分 类 号：R735.34[医药卫生—肿瘤]