围手术期血浆输注对胃癌手术病人预后影响研究(附255例分析)

Plasma infusion during perioperative period on the prognosis of the gastric cancer patients with gastrectomy:An analysis of 255 cases

目的探讨输血浆对胃癌病人的预后影响。方法回顾性分析2005年1月至2009年12月首都医科大学附属北京友谊医院行胃癌根治术或姑息胃切除手术治疗的255例胃癌病人临床资料,对影响行胃切除的胃癌病人预后因素进行Cox回归分析,并对其围手术期输血浆分层分析,判断其对胃癌病人存活率的影响。结果多因素回归分析显示幽门梗阻、TNM病理分期、围手术期输血浆和肿瘤直径≥6 cm是影响胃癌病人预后的独立危险因素。分层分析提示Ⅱ和Ⅲ期胃癌、肿瘤直径<6 cm、术前无低白蛋白血症、无贫血病人输血浆者预后更差,差异具有统计学意义(P<0.05)。结论围手术期输血浆是影响胃癌病人预后的独立危险因素,其中对Ⅱ和Ⅲ期胃癌、肿瘤直径<6 cm、术前无低白蛋白血症及无贫血病人的影响更大。

Objective To investigated the plasma infusion on the prognosis of the patients with gastric cancer. Methods The clinical data of the patients performed gastric resection from January 2005 to December 2009 in Beijing Friendship Hospital were analyzed retrospectively with COX regression. Then the perioperative plasma infusion was stratified to analyze its impact on gastric cancer survival. Results Multivariate survival analysis showed that pyloric obstruction,TNM stage,perioperative plasma infusion and tumor size≥6cm were independent prognostic factors. When stratified according to TNM stage,tumor size,preoperative hypoalbuminemia and anemia,plasma infusion group had significantly worse prognosis than no plasma infusion group in those stageⅡand stageⅢpatients,whose tumor size less than 6cm,those with preoperative hypoalbuminemia and those without anemia. The differences were significant（P〈0.05）. Conclusion In patients with gastric cancer, perioperative plasma infusion is an independent prognostic factor, which had greater influence on stage Ⅱand stage Ⅲ gastric cancer,tumor size less than 6cm,no preoperative hypoalbuminemia and no anemia patients.