乙状结肠癌性肠梗阻的特点、治疗及预后分析

The character,treatment and prognosis analysis for obstruction in sigmoid colon cancer

目的探讨乙状结肠癌患者梗阻特点及预后影响因素。方法选取我院2006-2010年收治的乙状结肠癌手术患者的临床资料,随访期大于3年,按梗阻程度（无梗阻,不完全性肠梗阻,完全性肠梗阻）进行分类并探讨各组临床特点;选择年龄（〉65岁、≤65岁）,性别,梗阻程度,肿瘤轴向线性长度（≥5cm、〈5cm）,组织浸润深度（黏膜层、黏膜下层、肌层、浆膜层）,TNM临床分期等因素对预后的影响进行统计学分析。结果完全性肠梗阻组肿瘤轴向长度更长,不完全性肠梗阻组次之,无梗阻组最短（P=0.001）。肠梗阻的梗阻程度越严重,术后并发症越多（P=0.009）。虽然三组之间术后化疗患者数差异有显著性,但趋势并未形成（P=0.22）。TNM分期与生存率相关（P=0.025）。结论梗阻程度并非影响乙状结肠癌预后的独立因素,但其临床特点和治疗方式值得关注;临床TNM分期是影响乙状结肠癌预后的因素。

Objective To investigate the characteristic, treatment and prognosis of obstruction in sigmoid colon cancer. Methods The demography, clinical characteristic and survival status of 62 patients with sig- mold colon cancer enrolled from 2006-2010 in Beijing Shunyi Hospital of China Medical University were assessed,More than three years follow-up period; Results The more severe obstruction in sigmoid colon cancer, the longer tumor axial length（ P =0. 001）. The more severe obstruction in sigmoid colon cancer, the more complications（ P = 0. 009 ）. Multivariate analysis revealed that TNM clinical stage was independ- ent prognostic factors（ P =0. 025）. Conclusion The severity of obstruction in sigmoid colon cancer is not independent prognostic factors but it＇s still deserve investigation.