贲门癌根治性全胃切除术与根治性近端胃切除术的比较分析

摘要

目的 探讨贲门癌根治性全胃切除术与根治性近端胃切除术的比较情况.方法 回顾性分析2013年3月～2015年9月宝鸡市中心医院收治的86例贲门癌患者临床资料,依据手术方式不同分为根治性全胃切除术组(43例)和根治性近端胃切除术组(43例).观察并比较两组贲门癌患者一般手术情况、手术治疗前后生活质量评分情况、术后并发症、术后复发率和1年生存率情况.结果 两组贲门癌患者手术时间、术中出血量、术后排气时间差异无统计学意义(P＞0.05),两组贲门癌患者治疗前和治疗后日常活动能力、日常生活状态、健康感受、社会支持度、生活感受评分差异无统计学意义(P＞0.05),两组贲门癌患者术后并发症发生率、复发率和1年生存率差异无统计学意义(P＞0.05).根治性近端胃切除术组贲门癌患者术后胃管引流量高于根治性全胃切除术组,治疗后根治性全胃切除术组和根治性近端胃切除术组日常活动能力、日常生活状态、健康感受、社会支持度、生活感受评分均高于治疗前,差异有统计学意义(P＜0.05).结论 贲门癌根治性全胃切除术与根治性近端胃切除术均具有较好的临床疗效,治疗后患者生活质量得到了提高,预后较好,值得临床推广应用.%Objective To dicuss comparison of cardia cancer by radical total gastrectomy and radical proximal gastrectomy.Methods from March 2013 to September 2015,in Center Hospital on Baoji City,the clinical data of 86 cardia cancer patients were retrospective analyzed,they were divided into two groups by different operation methods,radical total gastrectomy group (43 cases) and radical proximal gastrectomy group (43 cases).The general situation of operation,living quality score before and after treatment,postoperative complications,1 year survival rate of two groups were observed and compared.Results The operation time,intraoperative blood loss,postoperative exhaust time of two groups were compared,the difference was not statistically significant (P ＞ 0.05).The daily activity ability,daily life state,health feelings,social support,life apperception score of two groups before treatment and after treatment were compared,the difference was not statistically significant (P ＞ 0.05).The postoperative complications,postoperative recurrence rate and 1 year survival rate of two groups compared,the difference was not statistically significant (P ＞ 0.05).The postoperative gastric tube flow of radical proximal gastrectomy group were higher than that of radical total gastrectomy group,the daily activity ability,daily life state,health feelings,social support,life apperception score of radical total gastrectomy group and radical proximal gastrectomy group after treatment were higher than those before treatment,the differences were statistically significant (P ＜ 0.05).Conclusion The radical total gastrectomy and radical proximal gastrectomy of cardia cancer have good clinical effect,they can increase living quality of patients after treatment,the prognosis is good,it is worth to be used.