胃肠造瘘术在全梗阻型食管癌放疗中的应用  

Application of Gastrointestinal Fistulation to Fully Obstructive Esophageal Carcinoma Under Radiotherapy

作　　者：何晓军[1] 万志龙[1] 蔡晶[1] 马煌如[1] 

机构地区：[1]南通市肿瘤医院,江苏南通226361

出　　处：《河南肿瘤学杂志》2003年第3期197-198,共2页Henan Journal of Oncology

摘　　要：目的　评价胃肠造瘘术在全梗阻型食管癌放疗中的临床应用价值。方法　 98例全梗阻食管癌放疗病人 ,5 3例于疗前及疗中行胃肠造瘘术 ,其中照射剂量DT>5 0Gy为 2 7例 ,余 2 6例放疗剂量DT<5 0Gy ;45例于疗中仅予输液支持以维持放疗。结果　行胃肠造瘘术组kanofsky评分较对照组明显提高 ,体重亦维持或增加明显 ,两者比较P <0 0 0 5 ;胃肠造瘘术组与对照组其 1年及 3年生存率分别为 :33 9%、2 8 8%和 15 0 %、4 4% ,两组间生存率差异有显著性意义 ( χ2 =7 2 5 ,P =0 0 0 71) ;胃肠造瘘术组中放疗DT>5 0Gy与DT<5 0Gy病人其 1年及 3年生存率分别为 :48 1%、19 2 %及 2 2 2 %、7 7% ,两组间生存率统计学有显著差异 ( χ2 =4 2 0 ,P =0 0 40 4)。结论　全梗阻型食管癌疗前或疗中行胃肠造瘘术 ,可在改善病人体质状况、维持或增加体重基础上 ,明显提高患者 1年及3年的生存率 ,且放疗剂量DT 应 >5 0Gy。Objective To evaluate the value in the application of gastrointestinal fistulation to fully obstructive esophageal carcinoma under radiotherapy.Methods of the 98 patients with complete obstruction type of carcinoma of the esophagus,53 were subjected to gastrointestinal fistulation before and during radiation therapy,with irradiation dosage being larger than 50 Gy in 27 cases and smaller than 50 Gy in 26,and 45 were given fluid infusion so as to maintain radiation therapy.Results In the gastrointestinal fistulation group:Kanofsky marking was obviously higher than that in the control group (P<0.005).In the former group,the body weight was maintained or gained more evidently than in the latter (P<0.005).For the gastrointestinal fistulation and the control group,the 1-and 3-year survival rates were respectively 33.9%?28.8% and 15.0%?4.4%,there being a statistical difference (χ 2=7.25,P=0.007).In the fistulation groups whose irradiation dosage was larger than 50 Gy and smaller than 50 Gy,the patients' 1-and 3-year survival rates were respectively 48.1%?19.2% and 22.2%?7.7%,The differences were of remarkable statistical significance (χ 2=4.20,P=0.00404).Conclusions Gastrointestinal fistulation performed before and during radiotherapy of completely obstructive carcinoma of the esophagus helps improve the patients' condition,maintain or gain their weight,thus raising their 1-and 3-year survival rates,and the irradiation dosage should be larger than 50 Gy.

关 键 词：胃肠造瘘术 全梗阻型食管癌 放疗 临床应用 生存率 

分 类 号：R735.1[医药卫生—肿瘤]