全胃切除术和近端胃切除术治疗胃上部癌预后分析.docVIP

全胃切除术和近端胃切除术治疗胃上部癌预后分析 　　[摘要] 目的 对比分析胃上部癌患者分别采用全胃切除术以及近端胃切除术治疗的预后情况。方法 方便选取2008年3月―2017年5月在该院就诊的100例胃上部癌患者，按照不同的手术治疗方法随机分为实验组（50例，采用全胃切除术治疗）和对照组（50例，采用近端胃切除术治疗），对比两组患者术后1年营养状况、术后并发症发生率以及预后生存率及质量等情况。结果 实验组患者术后1年血浆总蛋白、血浆白蛋白以及血红蛋白等指标水平均低于对照组（P0.05），但实验组患者3年生存率60.0%、5年生存率36.0%明显高于对照组30.0%、16.0%。结论 胃上部癌患者采用全胃切除术以及近端胃切除术治疗均可取得良好的效果，近端胃切除术患者术后营养状况良好，全胃切除术患者远期生存率及生活质量更高，临床应根据患者实际情况选择合适的手术方式。 　　[?P键词] 胃上部癌；近端胃切除术；全胃切除术；预后分析 　　[中图分类号] R735 [文献标识码] A [文章编号] 1674-0742（2017）11（a）-0090-03 　　[Abstract] Objective To compare and analyze the prognosis of total gastrectomy and proximal gastrectomy in treatment of upper gastric cancer. Methods 100 cases of patients with upper gastric cancer diagnosed in our hospital from March 2008 to May 2017 were convenient selected and randomly divided into two groups with 50 cases in each， the experimental group and the control group were respectively treated with total gastrectomy and proximal gastrectomy， and the 1-year nutrition status， incidence rate of postoperative complications and prognosis survival rate and quality were compared between the two groups. Results The 1-year total plasma protein， plasma albumin and hemoglobin in the experimental group were lower than those in the control group（P0.05）， but the 3-year survival rate and 5-year survival rate in the experimental group were obviously higher than those in the control group，（60.0%，36.0% vs 30.0%，16.0%）. Conclusion Both total gastrectomy and proximal gastrectomy in treatment of upper gastric cancer can obtain a good effect， and the postoperative nutrition status of patients with proximal gastrectomy is good， and the long-term survival rate and quality of life of patients with total gastrectomy are higher， and we should select the proper operation method according to the practical conditions of patients. 　　[Key words] Upper gastric cancer； Proximal gastrectomy； Total gastrectomy； Analysis of prognosis 　　胃癌是一种常见的消化道恶性肿瘤，临床发病率较高，根据发病部位可分为下、中、上部癌，其中胃上部癌多发生在贲门至胃大小弯1/3 连线处[1]。胃上部癌的解剖结