胆肠、胃肠吻合姑息性旁路手术用于老年壶腹周围癌的临床观察

摘要

Objective To study the clinical effect of biliary-intestinal and gastrointestinal anastomosis palliative bypass surgery in elderly patients with periampullary carcinoma.Methods 212 elderly patients with periampullary carcinoma in our hospital from August 2012 to May 2014 were selected as the object of study,and randomly divided into observation group and control group,106 cases in each group.Patients in observation group underwent palliative surgery,while patients in control group underwent pancreatic duodenal resection.Compared biochemical indexes [bilirubin,albumin,hemoglobin (HB),alkaline phosphatase (ALP)],intraoperative bleeding volume,operation time,gastrointestinal function recovery time,the length of hospital stay,complications rate,and mortality of two groups.Results Postoperative bilirubin and ALP in observation group were significantly lower than those in control group (P＜0.05),albumin and hemoglobin were significantly higher (P＜0.05).Intraoperative bleeding volume,operation time,gastrointestinal function recovery time,the length of hospital stay in observation group were significantly less than those in control group (P＜0.05).The rate of complications and mortality in observation group were significantly lower than those in control group (34.9％ vs.64.2％,2.8％ vs.9.4％;P＜0.05).Conclusions Biliary-intestinal and gastrointestinal anastomosis palliative bypass surgery is effective in the treatment of elderly patients with periampullary carcinoma,which can accelerate the process of rehabilitation of patients,prolong patients' life,safe and reliable,worthy of clinical application and promotion.%目的 研究胆肠、胃肠吻合姑息性旁路手术用于老年壶腹周围癌的临床效果.方法 选取我院2012年8月至2014年5月212例老年壶腹周围癌患者为研究对象,将患者随机分为观察组和对照组,每组106例.观察组采用姑息性手术治疗,对照组采用胰十二指肠切除术治疗.比较两组的生化指标(胆红素、白蛋白、血红蛋白、碱性磷酸酶),术中出血量、手术时间、肠胃功能恢复时间、住院天数和并发症发生率、死亡率.结果 观察组术后胆红素、碱性磷酸酶指数显著低于对照组(P＜0.05),观察组术后白蛋白、血红蛋白指数显著高于对照组(P＜0.05).观察组术中出血量、手术时间、肠胃功能恢复时间、总住院天数显著少于或短于对照组(P＜0.05).观察组的并发症发生率、死亡率分别为34.9％、2.8％,显著低于对照组的64.2％、9.4％(P＜0.05).结论 胆肠、胃肠吻合姑息性旁路手术可以有效治疗老年壶腹周围癌,加快患者的康复进程,延长患者的生命,安全可靠,值得临床应用和推广.