70岁以上残胃癌患者的手术治疗方式及可行性分析  

Analysis of surgery treatment and feasibility of gastric stump carcinoma in the elderly patients over 70 years of age

作　　者：余稳稳[1,2] 陶瑞雨 闫开旭 刘宏斌[1] 

机构地区：[1]兰州军区兰州总医院普外科,甘肃兰州730050 [2]兰州大学,甘肃兰州730000

出　　处：《中国现代普通外科进展》2017年第4期268-271,共4页Chinese Journal of Current Advances in General Surgery

基　　金：国家科技部;财政部科技惠民计划项目(2012GS620101);甘肃省科技重大专项(2011GS04390)

摘　　要：目的:探讨70岁以上高龄残胃癌患者是否应接受手术治疗以及手术方式的选择。方法:回顾性分析2001年1月—2013年1月收治的36例活动状态评分0~3分且年龄>70岁,无明显手术禁忌证的残胃癌患者。将其分为手术治疗组和非手术治疗组;手术治疗组又分为根治性手术组和姑息性手术组。对各组治疗方式、术后并发症和生存情况进行分析。结果:手术治疗组1、3年存活率分别为45.5%、22.7%,而非手术治疗组1、3年存活率分别为18.2%、0,差异有统计学意义(P<0.05);其中,根治性手术组和姑息性手术组1、3年存活率分别为58.3%、33.3%和30.0%、10.0%,差异有统计学意义(P<0.05);根治性手术组和姑息性手术组的并发症发生率差异无统计学意义(P>0.05)。结论:70岁以上的高龄残胃癌患者依然可以从根治性手术中获益,姑息性手术对提高高龄残胃癌患者生存期无明显意义,根治性手术是高龄残胃癌患者适宜的手术方式。Objective： To investigate whether elderly patients over 70 years of age with gastric stump carcinoma should be treated with operation and which surgical approaches should be select- ed. Methods： A retrospective analysis was performed on 36 patients with gastric stump carcinoma without any significant surgical contraindications hospitalized in lanzhou general hospital of lanzhou military area from January 2001 to January 2013. All these patients were over 70 years of age, with an active score of 0-3. The patients were divided into surgical and non-surgical treatment groups, and the surgical treatment group was further subdivided into radical surgery group and palliative surgery group. The treatment modalities, complications and survival of each group were analyzed. Results： A one-year and a three-year survival rate of surgical treatment group was 45.5% and 22.7%, respectively, whereas the one-year and three-year survival rate of non-surgical treatment group was only 18.2% and 0%, the difference was statistically significant （P〈 0.05）. In the surgical treatment group, the radical surgery subgroup had a better survival rate than palliative surgery sub- group, with a one-year and a three-year survival rate of 58.3% and 33.3% respectively for the for- mer, and 30% and 10% for the latter. The incidence of complications of radical surgery group and palliative surgery group was of no significant difference （P 〉 0,05）. Conclusions： Elderly patients over 70 years of age with gastric stump carcinoma can still benefit from radical surgery; while pallia- tive surgery does not improve the survival rate of the patients, radical surgery is appropriate for el- derty patients with gastric stump carcinoma.

关 键 词：残胃癌 高龄 外科手术 存活率 

分 类 号：R735.2[医药卫生—肿瘤]