胆囊癌根治术或扩大根治术对Ⅳ期胆囊癌的疗效及预后分析

Analysis of the Prognosis of Patients with Gallbladder Carcinoma Treated by Radical Correction or Extended Radical Correction

目的分析胆囊癌根治术或扩大根治术治疗Ⅳ期胆囊癌的预后情况。方法选取62例Ⅳ期胆囊癌患者为研究对象,根据患者自身状况及病理特征,临床采用不同的治疗方式,其中有29例患者接受胆囊癌根治术或扩大根治术治疗,纳入观察组;有22例患者接受姑息性切除术治疗,纳入对照1组;有11例患者接受胆道内外引流术治疗,纳入对照2组,分别对三组患者进行2年随访,分析比较三组患者的预后情况。结果观察组患者术后中位生存时间为17.7个月,明显长于对照1组的10.4个月及对照2组的8.9个月,且差异均有统计学意义(P<0.05);观察组患者术后1年生存率(37.93%)及术后2年生存率(17.24%)均高于对照1组的18.18%、0和对照2组的9.09%、0(P<0.05);三组患者术后并发症主要为肝功能异常及胆瘘等,其并发症发生率分别为17.24%、18.18%及9.09%(P>0.05);手术方式、临床分期是影响Ⅳ期胆囊癌患者预后的独立危险因素(P<0.05)。结论采用胆囊癌根治术或扩大根治术治疗Ⅳ期胆囊癌,有助于改善患者的预后,延长患者术后生存时间。

Objective To study the prognosis of patients with gallbladder carcinoma treated by radical correction or ex- tended radical correction. Methods 62 cases of patients with stage 1V gallbladder carcinoma were selected as the research object. According to the patients＇own condition and pathological features ,29 cases were treated by radical resection of radical cholecystectomy or radical resection, and 22 cases were included in the observation group. The patients were treated with palliative resection and were included in the control group 1.11 patients were treated with internal and external drainage of the bile duct and included in the control group 2. The patients were followed up for 2 years. The prognosis of the 3 groups was compared. Results The median survival time was 17.7 months in the observation group,which was significantly longer than that of the control group 1 （ 10.4 months） and the control group 2 （8.9 months ） , and the difference was statistically significant （P 〈 0.05 ）. 1-year survival rate（37.93% ） and postoperative 2-year survival rate（ 17.24% ） of the observation group were higher than those of the control group 1,18.18% ,0, and the control group 2,9.09% ,0（ P 〈 0.05 ） The incidence of complications were 17.24% , 18.18% and 9.09% （P 〉 0.05 ）. The surgical procedure and clinical stage were the independent risk factors of the prognosis of patients with stage IV gallbladder carcinoma（ P 〈 0.05 ）. Conclusion The use of gallbladder radical surgery or radical resection for stage IV gallbladder cancer,it can help to improve the prognosis of patients, and extend the survival time of patients.