根治性切除手术与姑息性切除手术对老年胃癌患者的创伤、预后比较分析

Comparative analysis of the effects of radical resection and palliative resection on the prognosis of elderly patients with gastric cancer

目的探讨老年胃癌患者采用根治性切除手术或姑息性切除手术治疗对患者手术创伤、远期预后的影响作用。方法选取2003年1月至2013年4月手术治疗的137例老年胃癌患者进行回顾性研究,根据手术方法分为根治组78例、姑息组59例,对比两种手术方法对患者的手术创伤的影响;根据患者术后3年是否存活分为存活组和死亡组,统计软件采用SPSS16.0,手术时间、输血量、住院时间采用均数±标准差(x珋±s)表示,两组间比较采用t检验;并发症率、生存率等比较采用χ2检验;多因素分析采用非条件Logistic回归分析法;P值<0.05表示差异具有统计学意义。结果根治组患者的输血量显著的低于姑息组患者,差异具有统计学意义(P<0.05);术后2年、3年,根治组患者的的生存率分别为84.6%、59.0%均显著的高于姑息组的66.1%、33.9%,差异具有统计学意义(P<0.05);浸润深度越深、TNM分期越高、分化程度越低、姑息性手术方法是胃癌患者远期预后的危险因素(OR=1.772,OR=1.694,OR=1.593,OR=1.443),(P<0.05)。结论老年胃癌患者采用根治性切除手术较姑息性手术并不会增加手术创伤程度,同时对于患者远期预后具有积极作用。

Objective To investigate the effect of radical resection or palliative resection for the treatment of elderly patients with gastric cancer. Methods Selected retrospective study was conducted on 137 elderly patients with gastric cancer who underwent surgical treatment from January 2003 to April 2013, according to the patient ＂s surgical method was divided into radical group 78 cases, palliative group of 59 cases, compared with the two surgical methods on the surgical trauma of patients; according to whether the survival of patients after 3 years are divided into survival and death group, Statistical software using SPSS 16.0, operation time, blood transfusion, hospital stay using the mean -＋ standard deviation （x ＋ s） said, comparison of the two groups using t test; complication rate, survival rate comparison using X2 test; multivariate analysis using unconditional Logistic regression analysis ; P value 〈 0.05 that the difference was statistically significant. Results Significantly lower than the group of patients with radical palliative transfusion patients, the difference was statistically significant （ P 〈 0.05 ） ; after 2 years, 3 years, radical group of patients survival were 84.6% , 59.0% were significant 66. 1% higher than the palliative group, 33.9%, the difference was statistically significant （P 〈 0.05）; the deeper the depth of invasion, TNM stage, the higher, the lower the degree of differentiation, palliative surgical approach is a risk factor for long-term prognosis in patients with gastric cancer （ OR = 1. 772, OR = 1. 694, OR = 1. 593, OR = 1. 443）, （P 〈 0.05 ）. Conclusion Elderly patients with gastric cancer using radical surgical resection compared with palliative surgery does not increase the degree of surgical trauma, while long-tem~ prognosis for patients having a positive effect.