76例肝内胆管细胞癌合并糖尿病患者的预后结果分析

Prognostic analysis of 76 cases of intrahepatic cholangiocarcinoma complicated with diabetes mellitus

目的探讨肝内胆管细胞癌合并糖尿病患者的预后结果。方法将2009年1月—2014年10月在本院就诊的肝内胆管细胞癌患者152例作为研究对象。76例肝内胆管细胞癌合并糖尿病患者作为本次研究的观察组,并将同期进行诊治的76例不合并糖尿病的肝内胆管细胞癌作为对照组。通过对两组存活率、存活者12个月体质量指数、肿瘤转移、诺丁汉健康量表(NHP)(第一部分)评分结果等进行对比分析。结果存活率:6个月、9个月、12个月有显著差异,观察组显著低于对照组(P<0.05),两组在3个月的生存率无差异性(P>0.05)。存活时间12个月以上者,转移率:观察组显著高于对照组;NHP评分结果:在情感反应、活力、生理行动能力、疼痛和睡眠5个方面观察组显著高于对照组,社会孤独两组无显著差异;体质量指数:观察组体质量指数偏低率显著高于对照组,而体质量指数正常率显著低于对照组,体质量指数偏高方面,两组无差异性。结论糖尿病对肝内胆管细胞癌的预后影响是消极的,会降低其存活率及生活质量,增加肿瘤转移率。

Objective To investigate the prognosis of patients with intrahepatic cholangiocarcinoma combined with diabetes mellitus. Methods The study enrolled 152 cases of patients suffered from intrahepatic cholangiocarcinoma,and got therapy in our hospital during January 2009 and October 2014. The 76 cases of patients suffered from intrahepatic cholangiocarcinoma combined with diabetes mellitus were divided in to observation group,another 76 cases suffered intrahepatic cholangiocarcinoma were divided in to control group. The survival rate,body mass index of survivals,tumor metastasis,Nottingham Health Questionnaire（ NHP） score（ the first part） of the two groups were comparative analyzed.Results The survival rate of the observation group was significantly lower than that of the control group at 6 months,9 months and 12 months（ P〈0.05）. However,the survival rate of the two groups at 3 rd month had no significant difference（ P〉0. 05）. Among the patients survived for 12 months or more,the transfer rate of the observation group was significantly higher than the control group. NHP score results showed that the scores of emotional reaction,physiological activity,mobility,pain and sleep of observation group were significantly higher than the control group,but there was no significant difference on social loneliness between the two groups. Low body mass index rate of observation group significantly higher than the control group,the and normal body mass index was significantly lower than the control group,the high body mass index rate between the two groups had no difference. Conclusions The effect of diabetes on the prognosis of intrahepatic cholangiocarcinoma is negative,it will reduce the survival rate and quality of life,increase the rate of tumor metastasis.