内镜支架置入与手术治疗在不可切除晚期胃癌引起幽门梗阻中的疗效对比分析

Comparative Analysis on the Curative Effects of Endoscopic Stent Placement and Surgical Treatment in Pyloric Obstruction Caused by Unresectable Advanced Gastric Cancer

目的观察内镜支架置入和手术治疗在不可切除晚期胃癌引起幽门梗阻的患者中的疗效。方法选取我院2015年4月至2017年12月收治的晚期胃癌伴幽门梗阻患者115例,依据治疗方法分为支架组(n=54)和手术组(n=61)。对比两组患者的手术时间、术后GOOSS评分、恢复进食时间、住院时间、并发症发生率、通畅持续时间。对两组患者进行随访,观察其总生存期(OS)。结果两组患者的技术成功率、临床成功率比较均无统计学差异(P>0.05)。支架组的手术时间、术后恢复进食时间和住院时间均短于手术组(P <0.05)。支架组的GOOSS评分、并发症发生率均低于手术组(P <0.05)。支架组的通畅持续时间为(143.31±46.11) d,短于手术组的(301.12±56.41) d (P <0.05)。支架组的生存时间为(33.62±11.86)个月,短于手术组的(42.98±11.55)个月(P <0.05)。手术组的OS高于支架组(P <0.05)。结论内镜支架置入和手术治疗在不可切除晚期胃癌引起幽门梗阻的患者中的疗效均较佳。内镜支架置入的短期疗效较佳,而手术治疗能够较好地改善患者的预后情况。

Objective To observe the curative effects of endoscopic stent placement and surgical treatment in patients with pyloric obstruction caused by unresectable advanced gastric cancer. Methods 115 cases of patients with advanced gastric cancer and pyloric obstruction admitted to our hospital from April 2015 to December 2017 were selected and divided into stent group（n = 54） and surgical group（n = 61） according to the treatment methods. The surgical time, postoperative GOOSS score, feeding recovery time, hospitalization time, incidence of complications and unobstruction duration were compared between the two groups. Patients in two groups were followed up and the overall survival（OS） was observed. Results No statistical difference was found in the technical success rate and clinical success rate between the two groups（P 0.05）. The surgical time, feeding recovery time and hospitalization time of the stent group were shorter than those of the surgical group（P 0.05）. The incidence of complications and postoperative GOOSS score of the stent group were lower than those of the surgical group（P 0.05）. The unobstruction duration of the stent groups was（143.31 ± 46.11） d, shorter than（301.12 ± 56.41） d of the surgical group（P 0.05）. The survival time of the stent group was（33.62 ± 11.86） months, shorter than（42.98 ± 11.55） months of the surgical group（P 0.05）. The OS of the surgical group was higher than that of the stent group（P 0.05）. Conclusions Endoscopic stent placement and surgical treatment in patients with pyloric obstruction caused by unresectable advanced gastric cancer have better curative effects. Endoscopic stent placement has better short-term effect, and surgical treatment can better improve the prognosis of patients.