改良消化道重建术联合替吉奥口服化疗治疗胃癌患者的疗效

Efficacy of modified digestive tract reconstruction combined with tegafur oral chemotherapy in the treatment of patients with gastric cancer

目的 探讨改良消化道重建术联合替吉奥口服化疗治疗胃癌患者的应用效果及对纤维蛋白原、前白蛋白和肿瘤标志物水平的影响。方法 回顾性分析2018年1月~2021年3月我院收治的121例胃癌患者的临床资料,按治疗方式的不同分为观察组(改良消化道重建术联合替吉奥化疗,n=61)和对照组(传统消化道重建术联合替吉奥化疗,n=60)。比较两组患者的临床疗效,治疗前和治疗2月后两组患者的血液指标[纤维蛋白原(Fib)、前白蛋白(PA)]、肿瘤标志物[癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原72-4(CA72-4)、胃蛋白酶I(PGI)]变化;比较两组患者术后并发症(腹泻、吻合口漏、反流性食管炎、倾倒综合征及潴留综合征)的发生情况及两组营养评定指数(NAI)和胃肠道症状评分(GSRS)结果。结果 观察组临床有效率(95.09%)高于对照组(81.46%),疗效等级优于对照组(均P<0.05);治疗后,观察组Fib低于对照组,PA高于对照组(均P<0.05);治疗后,两组肿瘤标志物指标无明显差异(P>0.05),但两组患者肿瘤标志物指标均较治疗前改善(P<0.05);观察组并发症发生率(6.56%)低于对照组(21.67%)(P<0.05);治疗后,观察组NAI和GSRS评分均高于对照组(P<0.05)。结论 改良消化道重建术联合替吉奥口服化疗治疗胃癌患者疗效更显著,能够促进疾病恢复,改善预后,提高患者生活质量。

Objective To evaluate the application effect of modified digestive tract reconstruction combined with tegafur oral chemotherapy in the treatment of patients with gastric cancer.Methods The clinical data of 121 patients with gastric cancer treated in the hospital were collected between January 2018 and March 2021,and were divided into observation group(modified digestive tract reconstruction and postoperative conventional oxaliplatin combined with tegafur chemotherapy,61 cases)and control group(traditional digestive tract reconstruction and postoperative conventional oxaliplatin combined with tegafur chemotherapy,60 cases)for retrospective study according to different treatment methods.The clinical efficacy and changes in blood indicators such as fibrinogen(FIB)and prealbumin(PA)before treatment and after 2 months of treatment were compared between the two groups of patients.The changes in tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 72-4(CA72-4),pepsin I(PGI)]were analyzed in the two groups of patients.The occurrence of postoperative complications(diarrhea,anastomotic leakage,reflux esophagitis,dumping syndrome and retention syndrome)and Nutrition Assessment Index(NAI)and Gastrointestinal Symptom Rating Scale(GSRS)were compared.Results In terms of clinical efficacy,the clinical effective rate of 95.09%in observation group was higher than 81.46%in control group(P<0.05),and the efficacy grading of observation group was better than that of control group(P<0.05).As for blood indicators,the level of Fib after treatment of observation group was lower than that of control group while the level of PA was higher than that of control group(P<0.05).After treatment,there were no significant differences in the tumor markers between the two groups(P>0.05),but the tumor markers in the two groups were improved compared with those before treatment(P<0.05).The incidence rate of postoperative complications of 6.56%in observation group was lower than 21.67%in control group(P<0.05).(5)After treatment,the scores of quality of life of NAI and GSRS of observation group were higher than those of control group(P<0.05).Conclusion Modified digestive tract reconstruction combined with tegafur oral chemotherapy has a more significant efficacy in the treatment of patients with gastric cancer,and it can promote the disease recovery,improve the prognosis,and enhance the quality of life of patients.