全胃切除与近端胃切除治疗胃上部癌的临床近期与远期效果比较

Clinical short-term and long-term effect comparison of total gastrectomy and proximal gastrectomy in the treatment of upper gastric cancer

目的探讨不同方式胃切除治疗胃上部癌的临床近期与远期效果。方法选取我院2012年1月-2013年12月收治的胃上部癌患者共169例,按照手术方式的不同将其分为对照组和观察组,对照组患者接受近端胃切除治疗,观察组接受全胃切除治疗,比较两组患者手术一般情况、术后并发症发生率、术后2年生存率及转移率。结果观察组手术时间短于对照组,术中出血量少于对照组,差异有统计学意义（P〈0.05）。观察组术后血红蛋白及血清清蛋白水平明显高于对照组,差异有统计学意义（P〈0.05）。观察组术后并发症发生率与术后2年转移率明显低于对照组,生存率明显高于对照组,差异有统计学意义（P〈0.05）。结论全胃切除治疗胃上部癌有较好的临床效果,术后并发症发生率低,远期可提高生存率并降低转移率,值得临床推广应用。

Objective To explore the short-term and long-term effects by different gastrectomies on treating upper gastric cancer. Methods From January 2012 to December 2013,169 patients with upper gastric cancer admitted into our hospital were selected.According to different surgical methods,they were divided into control group and observation group.In the control group,patients were treated by proximal gastrectomy,while in the observation group,total gastrectomy was provided.The general condition of surgery,incidence of postoperative complications,and survival rate and metastasis rate 2 years after surgery were compared in the two groups. Results In the observation group,operation time was shorter and intraoperative amount of bleeding was less in comparison with those in the control group,the difference was statistically significant（P〈0.05）.The levels of hemoglobin and serum albumin after surgery in the observation group were much higher than those in the control group,the differences were statistically significant（P〈0.05）.In the observation group,incidence of postoperative complications and metastasis rate 2 years after surgery were both lower than those in the control group.The survival rate was greatly higher in comparison with that in the control group,the differences were statistically significant（P〈0.05）. Conclusion Total gastrectomy obtains a good effect on treating upper gastric cancer at advantages of low incidence of postoperative complications,improvement of survival rate and reduction of metastasis rate in a long term,which is worthy of clinical promotion and application.