胰头部肿瘤姑息治疗方法探讨

Palliative treatment in pancreatic head tumor

目的探讨不同条件下的胰头部肿瘤患者姑息治疗的方法及治疗效果。方法回顾性分析2005年1月至2015年12月在新疆医科大学第一附属医院收治的139例胰头部肿瘤患者的临床资料。根据患者的不同条件分为可切除组（45例）和不可切除组（94例）,根据治疗方式不同将两组细分为姑息手术组和支架组,共4个亚组。通过对生存时间及术后1个月白蛋白、总胆红素、并发症等指标的观察和对比分析,评价可切除组和不可切除组姑息手术治疗的情况。结果本研究139例患者术后获随访9~36个月。可切除组与不可切除组患者在住院时间方面比较,差异无统计学意义（P〉0.05）;而在生存时间及术后1个月白蛋白、总胆红素指标方面比较,差异有统计学意义（P〈0.05）。可切除组中,姑息手术组患者中位生存期大于支架组（P〈0.05）;不可切除组中,姑息手术组患者中位生存期小于支架组（P〈0.05）。结论对于胰头部肿瘤可切除但放弃行胰十二指肠根治术者,治疗方案更倾向于姑息手术治疗;而对于不可切除者,治疗方案更倾向于支架治疗。

Objective To explore therapeutic effect of palliative treatment in pancreatic head tumor of patients under different conditions. Methods A retrospective study was performed on 139 patients with pancreatic head tumor were received in The First Hospital Affiliated to Xinjiang Medical University from January 2005 to December 2015. According to the different conditions,patients with pancreatic head tumor were divided into the resectable group（ n = 45） and the unresectable group（ n = 94）. According to different treatments,patients were divided into the palliative surgery group and the stent group,totally 4 subgroups. Through the survival time and postoperative 1 month indices such as albumin,total bilirubin,complications of observation and comparative analysis to evaluate palliative treatment effects in resectable group and unresectable group. Results In this study,139 patients received postoperative follow-up for 9 ~ 36 months. There was no statistical significance in hospitalization time between the resectable group and unresectable group（ P 0. 05）; the survival time and postoperative 1 month of albumin,total bilirubin indicators,the difference was statistically significant（ P 0. 05）. In patients of the resectable group,surgery group median survival period was better than that in the stent group（ P 0. 05）; in patients of the unresectable group,surgery group median survival period was less than that in the stent group（ P 0. 05）.Conclusion For patients of the resectable group,selection is tend to be palliative surgery,and for patients of the unresectable group,selection is tend to be stent treatment.