根治性手术与姑息性手术对老年胃癌患者的临床疗效及术后创伤的影响

Clinical Efficacy and Postoperative Trauma of Radical Surgery and Palliative Surgery for Elderly Gastric Carcinoma

目的探讨根治性手术与姑息性手术对老年胃癌患者的临床疗效及术后创伤的影响。方法将89例老年胃癌患者,按照手术方式的不同分为根治性手术组46例与姑息性手术组43例。对2组患者术后创伤程度、术后生存质量恢复情况以及短期术后生存率进行观察与对比。结果根治性手术组患者术中出血量明显较姑息性手术组患者少,差异有统计学意义(P<0.05)。其他指标方面2组差异无统计学意义(P>0.05)。根治性手术组患者术后生活质量恢复改善率为50.00%、有效率为80.43%,姑息性手术组生活质量恢复改善率为23.26%、有效率为58.14%,根治性手术组明显高于姑息性手术组,差异有统计学意义(P<0.05)。根治性手术患者在6个月、1年及2年时的生存率均远远高于姑息性手术患者,差异具有统计学意义(P<0.05)。结论与姑息性手术相比,根治性手术并不会增加老年胃癌患者的手术创伤,并且对于患者术后生活质量及生存率均有积极意义,因此应当严格遵守根治性手术原则进行手术方案选择。

Objective To explore the clinical efficacy and postoperative trauma of radical surgery and palliative surgery for elderly gastric carcinoma .Methods 89 elderly patients with gastric carcinoma were retrospectively analyzed and divided into radical surgery group with 46 cases and palliative surgery group with 43 cases according to different methods of surgery .Then the grade of postoperative trauma ,improvement of life quality and survival rate of the 2 groups were observed and compared .Results Blood loss of radical surgery group was obviously lower than palliative surgery group , there had statistically significance （ P〈0.05）,but the other indexes had no statistically difference （P〉0.05）.The improvement rate of life quality and efficacy of radical surgery group were respectively 50.00%and 80.43%,which were obviously higher than palliative surgery group with 23.26%and 58.14%.6-month,1-year and 2-year survival rates of radical surgery group were obviously higher than palliative surgery group,there had statistically significance （P〈0.05）.Conclusion Compared to palliative surgery,radical surgery will not in-crease postoperative trauma and have positive effects in improvement of life quality and survival rate after surgery ,which suggest us follow the principles of radical surgery to choose surgery methods .