改良Devine术治疗晚期不可切除远端胃癌的临床疗效及患者近期预后影响因素分析  

Clinical efficacy of modified Devine procedure in the treatment of advanced unresectable distal gastric cancer and its influencing factors of short-term prognostic of patients

作　　者：尹航 王珊珊 刘培慧[3] YIN Hang;WANG Shanshan;LIU Peihui(Department of General Surgery,Longwan District,Huludao Central Hospital,Huludao,Liaoning,125000,China;Department of Hematology,Huludao Central Hospital Longwan Hospital,Huludao,Liaoning,125000,China;Department of Neurointerventional,Huludao Central Hospital Lianshan Hospital,Huludao,Liaoning,125000,China)

机构地区：[1]葫芦岛市中心医院龙湾院区普外科,辽宁葫芦岛125000 [2]葫芦岛市中心医院龙湾院区血液科,辽宁葫芦岛125000 [3]葫芦岛市中心医院连山院区神经介入科,辽宁葫芦岛125000

出　　处：《当代医学》2023年第20期73-76,共4页Contemporary Medicine

摘　　要：目的分析改良Devine术治疗晚期不可切除远端胃癌的临床疗效及患者近期预后的影响因素。方法选取2020年3—12月本院收治的60例晚期不可切除远端胃癌患者作为研究对象,按照随机数字表法均分两组,每组30例。对照组接受传统胃空肠吻合术治疗,观察组接受改良Devine术治疗,比较两组治疗效果(术中出血量、手术时间、术后胃管留置时间、术后1个月白蛋白水平)及术后1年生存率,采用多因素Logistic回归分析改良Devine术后患者近期预后的影响因素。结果观察组术中出血量少于对照组,手术时间、术后胃管留置时间均短于对照组,术后1个月白蛋白水平及术后1年生存率均高于对照组,差异有统计学意义(P<0.05)。不同性别患者术后1年生存时间比较差异无统计学意义;不同转移情况、病理类型、肿瘤大小、肿瘤部位、美国东部肿瘤协作组(ECOG)体力状态评分、年龄患者术后1年生存时间比较差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄>60岁、有远处淋巴结转移、器官转移和病理类型为印戒细胞癌、肿瘤位于全胃、肿瘤大小>10cm及ECOG体力状态评分>2分均为改良Devine术晚期不可切除远端胃癌患者预后不良的独立危险因素(OR>1,P<0.05)。结论改良Devine术治疗晚期不可切除远端胃癌患者治疗效果更佳,术后1年生存率更高,而年龄、肿瘤类型、肿瘤部位、肿瘤大小及转移情况均会影响患者近期预后,临床应根据患者的病情及相关影响因素给予针对性预防措施,以提高其生命质量。Objective To analyze the clinical efficacy of modified Devine procedure in the treatment of advanced unresectable distal gastric can-cer and its influencing factors of short-term prognosis of patients.Methods 60 patients with advanced unresectable distal gastric cancer treated in our hospital from March 2020 to December 2020 were selected as the study subjects,and they were divided into two groups according to the random number table method,with 30 cases in each group.The control group were treated with traditional gastrojejunostomy and the observation group were treated with modified Devine operation.The treatment effects(intraoperative bleeding,operation time,postoperative gastric tuberetention time,and albumin level at1 month after operation)and 1-year postoperative survival rate were compared between the two groups,the factors influencing the short-term prognosis of patients after modified Devine operation were analyzed by multivariate Logistic regression.Results The amount of intraop-erative bleedingin the observation group was less than that in the control group,the operation time and postoperative gastric tube retention time were shorter than those in the observation group,the albumin level at 1 month after operation and the 1-year postoperative survival rate were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in 1-year postoperative sur-vival time between different genders;there were significant differences in 1-year postoperative survival time between patients with different metastat-ic status,pathological type,tumor size,tumor site,ECOG physical status score,and age(P<0.05).Multivariate logistic regression analysis showed that the age>60 years old,presence of the distant lymph node metastasis,organ metastasis and pathological type of signet ring cell carcinoma,tu-mor site in the whole stomach,tumor size>10 cm,ECOG physical condition score>2 scores were all independent risk factors for poor prognosis in patients with a

关 键 词：晚期不可切除远端胃癌 改良DEVINE术 近期预后 影响因素 

分 类 号：R735.2[医药卫生—肿瘤]