全胃切除与近端胃切除术治疗胃底癌的临床价值比较  

Comparison of clinical value of total gastrectomy and proximal gastrectomy in the treatment of gastric fundus carcinoma

作　　者：辛海荣[1] 宋宇豹[1] 王龙跃[1] 高泽锋[1] Xin Hairong;Song Yubao;Wang Longyue;Gao Zefeng(Department of General Surgery, Shanxi Tumor Hospital, Taiyuan , Shanxi 030013 China)

机构地区：[1]山西省肿瘤医院普外二病区,山西省太原030013

出　　处：《中国基层医药》2018年第9期1130-1133,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 比较全胃切除与近端胃切除术治疗胃底癌的临床价值.方法 选择胃底胃癌患者80例,采用随机数字表法分为观察组、对照组,各40例,观察组实施全胃切除术,对照组则实施近端胃切除术.比较两组手术相关情况（手术时间、术中出血量、术后肛门排气时间）,统计两组术后病理R0切除比例及2年内生存情况.结果 观察组手术时间[（86.3±1.9）min]短于对照组[（102.3±2.6）min]（t=31.424,P〈0.05）,术中出血量[（180.5±15.0）mL]少于对照组[（230.0±25.0）mL]（t=10.738,P〈0.05）,肛门排气时间[（41.5±2.1）h]早于对照组[（56.9±3.3）h]（t=24.900,P〈0.05）;观察组术后病理R0切除率为32.5％（13/40）,高于对照组的5.0％（2/40）（χ2=8.205,P〈0.05）,1年生存率（92.5％）、2年生存率（67.5％）均显著高于对照组（60.0％、42.5％）（χ2=4.943、5.051,均P〈0.05）.结论 针对胃底部胃癌患者实施全胃切除,相对于近端胃切除术,手术时间短,术中出血少,术后恢复快,且提高病理切除比例及患者生存率.Objective To compare the clinical value of total gastrectomy and proximal gastrectomy in the treatment of gastric fundus carcinoma. Methods 80 patients with gastric fundus cancer were divided into observation group and control group according to the random number method. The observation group was treated with total gastrectomy, and the control group was treated by proximal gastrectomy. The operation - related conditions, such as operation time, intraoperative bleeding and postoperative anal exhaust time of the two groups were compared, After surgery R0 resection rate and 2 - year survival rate were analyzed. Results The operative time in the observation group was （86.3 ± 1.9）min,wbich was shorter than （ 102.3 ±2.6）min in the control group （t =31. 424,P 〈0.05）. The iutraoperative blood loss of the observation group was （ 180.5 ± 15.0 ） mL, which was less than （ 230.0 ± 25.0 ） mL of the control group （ t = 10. 738 ,P 〈 0. 05 ）. The anal exhaust time of the observation group was （41.5 ± 2.1 ） h ,which was shorter than （56.9 ± 3.3 ） h of the control group （ t = 24. 900, P 〈 0.05 ）. The percentage of pathologic R0 resection of the observation group was 32.5 % （ 13/40）, which was higher than 5.0% （2/40） of the control group （ χ2 = 8. 205, P 〈 0.05）. The 1 - year survival rate and 2 - year survival rate in the observation group were 92, 5% ,67.5% ,respectively, which were significantly higher than those in the control group（60.0% ,42.5% , χ2 =4. 943,5. 051, all P 〈 0.05 ）. Conclusion Compared with the proximal gastreetomy, the total gastrectomy in the treatment of gastric fuudus carcinoma has shorter operation time, hess intraoperative blood loss, quicker postoperative recovery, higher pathologic resection rate and survival rate.

关 键 词：胃肿瘤 胃切除术 临床对照试验 

分 类 号：R735.2[医药卫生—肿瘤]