联合门静脉/肠系膜上静脉切除重建的胰腺癌根治术术后并发症及生存预后分析  

Analysis on postoperative complications and survival prognosis of radical resection of pancreatic cancer combined with portal vein/superior mesenteric vein resection

作　　者：郝德彦[1] 阿斯楞[2] 赵建国[2] 张萌 HAO De-yan;A si-leng;ZHAO Jian-guo(Department of Anesthesia,Inner Mongolia Medical University AffiliateHospital,Hohhot,Inner Mongolia 010050,China;Department of Hepatobiliary Pancreatic and Splenic Surgery,Inner Mongolia Medical University AffiliateHospital,Hohhot,Inner Mongolia 010050,China.)

机构地区：[1]内蒙古医科大学附属医院麻醉科,内蒙古呼和浩特010050 [2]内蒙古医科大学附属医院肝胆胰脾外科,内蒙古呼和浩特010050

出　　处：《临床和实验医学杂志》2019年第17期1894-1896,共3页Journal of Clinical and Experimental Medicine

基　　金：内蒙古自治区高等学校科学技术研究项目(编号:NJZY16116)

摘　　要：目的探讨联合门静脉(PV)/肠系膜上静脉(SMV)切除重建的胰腺癌根治术术后并发症及生存预后情况。方法回顾性分析2015年6月至2017年12月内蒙古医科大学附属医院收治的68例胰腺癌患者的临床资料,依据手术方式的不同分为两组:对照组40例和观察组28例。两组均行胰十二指肠切除术、胰尾癌根治术治疗。对照组术中不进行血管切除重建;观察组患者手术过程中,如果证实有PV/SMV侵犯,同时采取PV/SMV切除重建术治疗。比较两组患者手术时间、术中出血量、术后住院天数、术后并发症、生存率情况。结果观察组患者手术时间(486. 4±100. 2min)、术中出血量(950. 9±167. 4 ml)、术后住院天数(33. 8±12. 9 d)、术后菌血症发生率28. 6%、6个月生存率85. 7%、1年生存率64. 3%均高于对照组(400. 8±90. 2 min、447. 2±150. 2 ml、24. 2±10. 6 d、10. 0%、55. 0%、40. 0%),切口感染率(0)低于对照组(7. 5%),差异均有统计学意义(P <0. 05)。结论联合PV/SMV切除重建的胰腺癌根治术,虽然增加了手术时间、出血量和住院天数,但是明显提高了患者术后6个月、1年的生存率,值得临床推广应用。Objective To explore the postoperative complications and survival prognosis analysis on pancreatic cancer radical surgery by combination with portal vein/superior mesenteric vein(PV/SMV)resection. Methods The clinical data of 68 patients with pancreatic cancer in this hospital during June 2015 to December 2017 were retrospective analyzed. These patients were divided into two groups by different operation methods, 40 cases in control group and 28 cases in observation group. Pancreatic duodenectomy or pancreatic tail cancer radical resection in these two group were taken. Patients in.control group were treated by reconstruction without vascular resection;in patients with operation detection group, which were violated with PV/SMV, then PV/SMV excision and reconstruction were taken. The operating time, volume of intraoperative bleeding, hospital stay days after operation, postoperative complications, survival rate of patients in these two groups were compared. Results The operating time (486.4±100.2 min), volume of intraoperative bleeding (950.9±167.4 ml), hospitalization days after operation (33.8±12.9 d), postoperative bacteremia 28.6%, survival rate of 64.3% in 6 month, survival rate was 64.3% in 1 year of patients in detection group, they were higher than those of control group (400.8±90.2 min, 447.2±150.2 ml, 24.2±10.6 d, 10.0%, 55.0%, 40.0% of control group), cutting lesion infection 0 was lower than 7.5% of control group, and the difference was statistically significant ( P <0.05). Conclusion The resection of pancreatic cancer by combination with PV/SMV resection, which increase the operating time, volume of intraoperative bleeding, hospitalization days after operation, but it can increase the survival rate after operation in 6 month and 1 year. Hence it is worthy to be applied.

关 键 词：胰腺癌根治术 门静脉 肠系膜上静脉 并发症 生存预后 

分 类 号：R735.9[医药卫生—肿瘤]