单纯、根治性切除术治疗Ⅱ期原发性胆囊癌的临床效果比较

Comparison of clinical effects of simple and radical resection for stage Ⅱ primary gallbladder carcinoma

目的比较单纯、根治性切除术治疗Ⅱ期原发性胆囊癌的临床效果。方法将我院收治的100例Ⅱ期原发性胆囊癌患者以随机数表法分为观察组与对照组,各50例。观察组实施根治性腹腔镜胆囊切除术,对照组实施单纯的腹腔镜胆囊切除术。比较两组手术时间、出血量、术后首次排气时间、术后首次排便时间、术后首次进食时间、术后首次下床时间、住院时间及术后1、3、5年生存率,并观察两组手术前、后生活质量及术后1年并发症发生情况。结果观察组的手术时间显著长于对照组,差异具有统计学意义(P<0.05);两组的出血量、术后首次排气时间、术后首次排便时间、术后首次进食时间、术后首次下床时间及住院时间比较,差异无统计学意义(P>0.05)。观察组的中位生存期显著长于对照组,术后1、3、5年生存率显著高于对照组,差异具有统计学意义(P<0.05)。观察组术后精神、食欲、疲乏、疼痛、日常活动评分及总分均高于术前及对照组,差异具有统计学意义(P<0.05)。两组术后并发症总发生率比较,差异不具有统计学意义(P>0.05)。结论根治性腹腔镜胆囊切除术可更好地延长Ⅱ期胆囊癌患者生存时间,提高患者生活质量,安全性较高,值得临床应用。

Objective To compare the clinical effects of simple and radical resection for stageⅡprimary gallbladder carcinoma.Methods One hundred patients with stageⅡprimary gallbladder carcinoma were divided into observation group and control group by random number table method,with 50 cases in each group.The observation group underwent radical laparoscopic cholecystectomy,while the control group underwent simple laparoscopic cholecystectomy.The operation duration,bleeding volume,first exhaust time after operation,first defecation time after operation,first eating time after operation,first getting out of bed time after operation,hospitalization time and survival rate of 1,3 and 5 year after operation were compared between the two groups,the quality of life before and after operation and the occurrence of complications at 1 year after operation of the two groups were observed.Results The operation duration in the observation group was significantly longer than that in the control group,and the difference was statistically significant(P<0.05);there were no significant differences in bleeding volume,first exhaust time after operation,first defecation time after operation,first eating time after operation,first getting out of bed time after operation and hospitalization time between the two groups(P>0.05).The median survival time of the observation group was significantly longer than that of the control group,and the survival rate of 1,3 and 5 year after operation of the observation group were significantly higher than those of the control group,and the differences were statistically significant(P<0.05).The scores of mental,appetite,fatigue,pain,daily activities and total scores in the observation group were higher than those before operation and in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion Radical laparoscopic cholecystectomy can better prolong the survival time of patients with stage Ⅱ gallbladder carcinoma,improve the quality of life of patients,and has high safety,it is worth clinical application.