多术式联合治疗T1a期胆囊癌的疗效及安全性分析  

Efficacy and safety analysis of combined therapy of multiple operation for T1a stage gallbladder cancer

作　　者：张宇 刘振文 张晓峰 李志杰 王洪波 辛大平 Zhang Yu;Liu Zhenwen;Zhang Xiaofeng;Li Zhijie;Wang Hongbo;Xin Daping(Fifth Medical Center of PLA General Hospital Second center of hepatobiliary surgery,100039;General Hospital of Guang’an People’s Hospital,One Section,638000)

机构地区：[1]解放军总医院第五医学中心肝胆外科二中心,北京100039 [2]广安市人民医院普外一科,四川638000

出　　处：《中华普外科手术学杂志（电子版）》2020年第3期233-236,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：四川省卫生计生委科研课题项目(16PJ594)。

摘　　要：目的分析多术式联合治疗T1a期胆囊癌的疗效及安全性。方法回顾性分析2016年1月至2019年1月80例T1a期胆囊癌患者临床资料,将接受完全腹腔镜下胆囊切除+淋巴清扫+射频消融治疗的32例患者纳入腔镜组,将接受开腹胆囊切除+淋巴清扫+射频消融治疗的48例患者纳入开腹组。采用SPSS 21.0软件包进行分析。手术疗效、术后并发症采用χ^2检验;手术相关指标、中国癌症病人生活质量调查问卷(QOL)评分用(±s)描述,采用独立t检验,P<0.05为差异有统计学意义。结果腔镜组手术总有效率(93.8%)略高于开腹组(89.6%),术后并发症总体发生率(6.3%)略低于开腹组(20.8%),但差异均无统计学意义(P>0.05);腔镜组手术时间、术后排气时间、术后住院时间和术中出血量均少于开腹组(P<0.05);腔镜组术后6个月QOL量表中食欲、精神、疼痛、疲乏、日常活动及家人理解度评分均比开腹组高(P<0.05)。结论多术式联合治疗T1a期胆囊癌的疗效相当,但相比开腹组,腹腔组创伤小、出血量低、术后并发症少,且更利于改善生活质量。Objective To analyze the efficacy and safety of combined therapy of multiple operation for T1a stage gallbladder cancer.Methods The clinical data of 80 patients with stage T1a gallbladder cancer treated in our hospital from January 2016 to January 2019 were retrospectively analyzed.32 patients who underwent laparoscopic cholecystectomy+lymphadenectomy+radiofrequency ablation were included in the laparoscopy group,48 patients who underwent open cholecystectomy+lymphadenectomy+radiofrequency ablation were included in the open group.SPSS 21.0 software package was used to analyze the entire group of data.Surgical curative effect,postoperative complication frequency(n),rate(%)were described,andχ^2 test was used;surgical-related indicators,and the quality of life questionnaire(QOL)score for Chinese cancer patients were used description,and compared with t test,P<0.05 was considered statistically significant.Results The total effective rate(93.8%)in the laparoscopic group was slightly higher than that in the open group(89.6%).The overall incidence of postoperative complications(6.3%)was slightly lower than that in the open group(20.8%),but the differences were not statistically significant(P>0.05);the operation time,postoperative exhaust time,and postoperative hospital stay in the laparoscopic group were shorter than those in the open group,and the intraoperative blood loss was less than that in the open group(P<0.05).In the laparoscopic group,the appetite,mental,pain,fatigue,daily activities,and family comprehension scores of the QOL scale at 6 months after operation were higher than those of the open group(P<0.05).Conclusion Bothe of the combined therapy of multiple operation for T1a stage gallbladder cancer is quite effective,but compared with open cholecystectomy+lymph dissection+radiofrequency ablation,laparoscopic cholecystectomy+lymph dissection+radiofrequency ablation has less trauma,lower bleeding,which postoperative complications are fewer and more conducive to improving quality of life.

关 键 词：T1a期胆囊癌 胆囊切除术 腹腔镜 淋巴结切除术 手术后并发症生活质量 射频消融 

分 类 号：R73[医药卫生—肿瘤]