术前ASA分级及手术范围对胃癌根治术患者预后的影响

Influence of preoperative ASA classification and scope of surgical operation on prognosis of gastric cancer after radical gastrectomy

目的:探讨术前ASA分级及手术范围对不同年龄胃癌根治术后患者预后的影响。方法:回顾性分析188例首次行胃癌根治术的患者资料,根据ASA分级、手术范围、年龄,分别将患者区分为ASA高值(分级≥3)与ASA低值(分级<3)患者、胃全切与胃部分切除患者、中青年(<60岁)与老年(≥60岁)患者,比较不同因素分组的患者术后生存时间。结果:生存分析结果显示,ASA高值组术后生存时间短于ASA低值组(P<0.05);中青年患者中,胃部分切除者生存时间长于全胃切除者(P<0.05);老年患者中,胃部分切除者生存时间与全胃切除组生存时间差异无统计学意义(P>0.05);ASA高值患者中,胃部份切除者生存时间与全胃切除者生存时间差异无统计学意义(P>0.05);而ASA低值患者中,胃部分切除患者生存时间长于全胃切除患者(P<0.05)。结论:ASA分级可作为胃癌根治术患者预后判断的指标,对中青年及术前ASA分级低患者应严格掌握手术范围,尽量避免不必要的大范围手术。

Objective： To investigate the influence of preoperative ASA dassification and scope of surgical operation on the prognosis of gastric cancer after radical operation in patients of different ages Methods： The clinical data of 188 gastric cancer patients who underwent primary radical resection were retrospectively analyzed. According to the ASA classification, scope of surgical operation and age, the patients were distinguished into high ASA score （score_〉3） and low ASA score （score〈3） patients, total gastrectomy group and partial gastrectomy patients, and young, middle-aged （〈60 years of age） and old-aged （_〉60 years of age） patients, respectivel）n The postoperative survival time between patients grouped by above factors was compared. Results： Survival analysis showed that the postoperative survival time in patients with high ASA score was shorter than that in patients with low ASA score （P〈0.05）; the postoperative survival time in patients undergoing partial gastrectomy was longer than that in those undergoing total gastrectomy among the young, middle-aged （P〈0.05）,while there was no significant difference among the old-aged （P〉0.0S）; the postoperative survival time had no significant difference between patients undergoing partial gastrectomy and total gastrectomy among those with high ASA score （P〉0.05）, but which was longer in the former than that in the latter among those with low ASA score （P〈0.05）.Conclusion： ASA classification can be used to estimate the prognosis of gastric cancer patients after radical operation. The scope of surgical operation should be strictly controlled in young patients and patients with low preoperative ASA score, and unnecessarily extended operation should be avoided.