内镜下支架置入术对胃癌所致幽门梗阻的疗效观察  

Endoscopic stent implantation in pyloric obstruction caused by gastric cancer

作　　者：刘亮 朱旭 张超 韩晓书 LIU Liang;ZHU Xu;ZHANG Chao;HAN Xiaoshu(Department of Gastroenterology,Fushun Central Hospital,Fushun 113006,Liaoning,China)

机构地区：[1]抚顺市中心医院消化内科,辽宁抚顺113006

出　　处：《癌症进展》2020年第23期2439-2441,2456,共4页Oncology Progress

摘　　要：目的探讨内镜下支架置入术对胃癌所致幽门梗阻的治疗效果。方法根据手术方式将76例胃癌合并幽门梗阻患者分为对照组(n=49)和观察组(n=27),对照组患者接受传统开腹手术或腹腔镜手术,观察组患者接受内镜下支架置入术。比较两组患者一次手术成功率、一般手术指标(手术时间、术中出血量、首次进食时间、首次下床时间、胃肠恢复时间及术后住院时间)、疼痛程度和近期并发症发生情况;比较两组患者围手术期的死亡情况、2年生存及复发情况。结果两组患者一次手术成功率、近期并发症发生率、随访2年的生存率和复发率比较,差异均无统计学意义(P> 0.05)。观察组患者手术时间、首次进食时间、首次下床时间、胃肠功能恢复时间及术后住院时间均明显短于对照组患者,术中出血量明显低于对照组患者,差异均有统计学意义(P <0.01)。术后1、3、7 d,观察组患者的视觉模拟评分法(VAS)评分低于对照组患者,差异有统计学意义(P <0.05)。结论内镜下支架置入术治疗胃癌合并幽门梗阻可达到与外科手术相同的治疗效果,同时具有创伤小、术后恢复快、住院时间短的优点。Objective To observe the therapeutic effect of endoscopic stent implantation in pyloric obstruction caused by gastric cancer.Method According to the surgical method,76 patients with gastric cancer and pyloric obstruction were divided into control group(n=49)and observation group(n=27),the control group received conventional laparotomy or laparoscopic surgery,and the observation group received endoscopic stent implantation.The success rate of first operation,the general condition of operation(operation time,intraoperative blood loss,time to first feeding,time to first ambulation,gastrointestinal function recovery time and postoperative hospitalization time),pain intensity,short-term complications.The perioperative.death,2-year survival and recurrence of the two groups were compared.Result There were no significant differences in the success rate of first operation,incidence of short-term complications,2-year survival rate and recurrence rate between the two groups(P>0.05).The operation time,time to first feeding,time to first ambulation,gastrointestinal function recovery time and postoperative hospitalization time of the patients in the observation group were significantly shorter than those in the control group,and the intraoperative blood loss was significantly lower than that of the patients in the control group(P<0.01).1,3 and 7 days after operation,the scores of visual analogue scale(VAS)in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Endoscopic stent implantation can achieve the same therapeutic effect as surgical operation for patients with gastric cancer complicated with pyloric obstruction,which has the advantages of less trauma,quick postoperative recovery and short hospitalization.

关 键 词：内镜下支架置入术 胃癌 幽门梗阻 生存情况 

分 类 号：R735.2[医药卫生—肿瘤]