年龄调整的Charlson合并症指数影响腹腔镜胃癌根治术患者预后的多中心回顾性研究  

Influences of age-adjusted Charlson comorbidity index on prognosis of patients undergoing laparoscopic radical gastrectomy:a multicenter retrospective study

作　　者：王祖凯 林建贤[1] 许燕常 赵刚[3] 蔡丽生 李国新[5] 徐泽宽[6] 燕速[7] 吴祖光[8] 薛芳沁[9] 孙益红[10] 许东波[11] 张文斌[12] 余佩武 万进 胡建昆[15] 苏向前[16] 季加孚[16] 李子禹[16] 尤俊[17] 李勇[18] 樊林[19] 谢建伟[1] 李平[1] 郑朝辉[1] 黄昌明[1] Zukai Wang;Jianxian Lin;Yanchang Xu;Gang Zhao;Lisheng Cai;Guoxin Li;Zekuan Xu;Su Yan;Zuguang Wu;Fangqin Xue;Yihong Sun;Dongbo Xu;Wenbin Zhang;Peiwu Yu;Jin Wan;Jiankun Hu;Xiangqian Su;Jiafu Ji;Ziyu Li;Jun You;Yong Li;Lin Fan;Jianwei Xie;Ping Li;Chaohui Zheng;Changming Huang(Department of Gastric Surgery,Fujian Medical University Union Hospital,Fuzhou 350001,China;Department of Gastrointestinal Surgery,the First Hospital of Putian City,Putian 351100,Fujian Province,China;Department of Gastrointestinal Surgery,Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200025,China;Department of General Surgery,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou 363099,Fujian Province,China;Depart-ment of General Surgery,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of General Surgery,the First Affiliated Hospital with Nanjing Medical University,Nanjing 210029,China;Department of Gastrointestinal Surgery,Qinghai University Affiliated Hospital,Xining 810012,China;The Second Department of General Surgery,Meizhou People′s Hospital,Meizhou 514031,Guangdong Province,China;Department of Gastrointestinal Surgery,Fujian Provincial Hospi-tal,Fuzhou 350001,China;Department of General Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of General Surgery,Longyan First Hospital,Longyan 364099,Fujian Province,China;Department of General Surgery,the First Affiliated Hospital of Xinjiang Medi-cal University,Urumqi 830054,China;Department of General Surgery,the First Affiliated Hospital of Army Medical University,Chongqing 400038,China;Department of General Surgery,the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510515,China;Department of Gastrointestinal Surgery,West China Hospital,Sichuan University,Chengdu 610041,China;Gastrointestinal Cancer Center,Beijing University Cancer Hospital,Beijing 100142,China;Department of Gastrointestinal Surgery,the First Affiliated Hospital of Xiam

机构地区：[1]福建医科大学附属协和医院胃外科,福州350001 [2]莆田市第一医院胃肠外科,莆田351100 [3]上海交通大学医学院附属仁济医院胃肠外科,上海200025 [4]福建医科大学附属漳州市医院普通外科,漳州363099 [5]南方医科大学南方医院普通外科,广州510515 [6]南京医科大学第一附属医院普通外科,南京210029 [7]青海大学附属医院胃肠外科,西宁810012 [8]梅州市人民医院普外二科,梅州514031 [9]福建省立医院胃肠外科,福州350001 [10]复旦大学附属中山医院普通外科,上海200032 [11]龙岩市第一医院普通外科,龙岩364099 [12]新疆医科大学附属第一医院普通外科,乌鲁木齐830054 [13]陆军军医大学第一附属医院普通外科,重庆400038 [14]广州中医药大学第二附属医院普通外科,广州510515 [15]四川大学华西医院胃肠外科,成都610041 [16]北京大学肿瘤医院胃肠肿瘤中心,北京100142 [17]厦门大学附属第一医院胃肠外科,厦门361003 [18]广东省人民医院胃肠外科,广州510080 [19]西安交通大学第一附属医院普通外科,西安710061

出　　处：《中华消化外科杂志》2022年第5期616-627,共12页Chinese Journal of Digestive Surgery

基　　金：福建省科技创新联合资金项目(2017Y9011)。

摘　　要：目的探讨年龄调整的Charlson合并症指数(ACCI)对腹腔镜胃癌根治术患者预后的影响。方法采用回顾性队列研究方法。收集2016年9月至2017年10月中国腹腔镜胃肠外科研究组-04研究中19家医院收治的242例(福建医科大学附属协和医院54例、莆田市第一医院32例、上海交通大学医学院附属仁济医院32例、福建医科大学附属漳州市医院31例、南方医科大学南方医院17例、南京医科大学第一附属医院11例、青海大学附属医院8例、梅州市人民医院8例、福建省立医院7例、复旦大学附属中山医院6例、龙岩市第一医院6例、新疆医科大学附属第一医院5例、陆军军医大学第一附属医院5例、广州中医药大学第二附属医院4例、四川大学华西医院4例、北京大学肿瘤医院4例、厦门大学附属第一医院3例、广东省人民医院3例、西安交通大学第一附属医院2例)行腹腔镜胃癌根治术患者的临床病理资料;男193例,女49例;年龄为62(23~74)岁。观察指标:(1)患者年龄分布与合并症及ACCI情况。(2)ACCI分组及临床病理特征比较。(3)术后早期并发症发生情况及术后早期并发症影响因素分析。(4)随访情况。(5)影响患者3年无复发生存率的因素分析。采用门诊或电话方式进行随访,了解患者术后生存情况。随访时间截至2020年12月。正态分布的计量资料以x±s表示,组间比较采用t检验;偏态分布的计量资料以M(Q_(1),Q_(3))或M(范围)表示,组间比较采用Mann-Whitney U检验。计数资料以绝对数或百分比表示,组间比较采用χ^(2)检验或Fisher确切概率法。等级资料比较采用非参数秩和检验。采用X-Tile软件(3.6.1)分析ACCI分组临界值。采用Kaplan-Meier法计算生存率和绘制生存曲线,采用Log-Rank检验进行生存分析。采用Logistic回归模型分析术后早期并发症影响因素。采用COX比例风险模型进行3年无复发生存率影响的单因素和多因素�Objective To investigate the influences of age-adjusted Charlson comorbidity index(ACCI)on prognosis of patients undergoing laparoscopic radical gastrectomy.Methods The retrospective cohort study was conducted.The clinicopathological data of 242 gastric cancer patients who underwent laparoscopic radical gastrectomy in 19 hospitals of the Chinese Laparoscopic Gastrointestinal Surgery Study Group-04 study,including 54 patients in Fujian Medical University Union Hospital,32 patients in the First Hospital of Putian City,32 patients in Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine,31 patients in Zhangzhou Affiliated Hospital of Fujian Medical University,17 patients in Nanfang Hospital of Southern Medical University,11 patients in the First Affiliated Hospital with Nanjing Medical University,8 patients in Qinghai University Affiliated Hospital,8 patients in Meizhou People′s Hospital,7 patients in Fujian Provincial Hospital,6 patients in Zhongshan Hospital of Fudan University,6 patients in Longyan First Hospital,5 patients in the First Affiliated Hospital of Xinjiang Medical University,5 patients in the First Hospital Affiliated to Army Medical University,4 patients in the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,4 patients in West China Hospital of Sichuan University,4 patients in Beijing University Cancer Hospital,3 patients in the First Affiliated Hospital of Xiamen University,3 patients in Guangdong Provincial People′s Hospital,2 patients in the First Affiliated Hospital of Xi′an Jiaotong University,from September 2016 to October 2017 were collected.There were 193 males and 49 females,aged 62(range,23‒74)years.Observation indicators:(1)age distribution,comorbidities and ACCI status of patients;(2)the grouping of ACCI and comparison of clinicopathological characteristics of patients in each group;(3)incidence of postoperative early complications and analysis of factors affecting postoperative early complications;(4)follow-up;(5)analysis

关 键 词：胃肿瘤 全胃切除术 年龄 术前合并症 年龄调整的Charlson合并症指数 术后早期并发症 预后 腹腔镜检查 

分 类 号：R735.2[医药卫生—肿瘤]