摘要
目的研究腹腔镜直肠全系膜切除术联合动脉置泵灌注化疗治疗中晚期直肠癌的疗效及对预后生存质量的影响。方法将2014年1月至2015年6月于本院接受诊治的中晚期直肠癌患者96例纳入观察对象,参照治疗方案不同分对照组、研究组,各48例。对照组患者接受单独的腹腔镜直肠全系膜切除术治疗,研究组患者接受腹腔镜直肠全系膜切除术联合动脉置泵灌注化疗治疗。对比分析2组患者术后临床指标、预后生存质量及并发症发生率。结果研究组术后指标(下床时间、肛门排气、进食及住院时间)较对照组短,差异有统计学意义(P<0.05);研究组患者治疗总效率90%(43/48)高于对照组的58%(28/48),差异有统计学意义(P<0.05);术后,2组患者的生存质量KPS评分升高,研究组更高,差异有统计学意义(P<0.05);研究组患者术后并发症发生率10%(5/48)略高于对照组的6%(3/48),但差异无统计学意义(P>0.05);术后3年,研究组生存率92%(44/48)高于对照组的75%(36/48),差异有统计学意义(χ~2=21.104,P=0.004)。结论腹腔镜直肠全系膜切除术联合动脉置泵灌注化疗治疗中晚期直肠癌疗效显著,安全性高,能缩短患者术后恢复时间,改善患者预后生存质量,值得临床推广。
Objective To investigate the therapeutic efficacy of laparoscopic total mesorectal excision combined with arterial chemotherapy infusion for mid-to-late stage rectal cancer and its impact on prognosis and quality of life. Methods Included in this study were 96 patients with mid-to-late stage rectal cancer treated in our hospital between January 2014 and June 2015. According to the treatment regimens received, they were divided into a control group and a study group(n=48 each). The patients in the control group underwent laparoscopic total mesorectal excision alone, while those in the study group underwent laparoscopic total mesorectal excision combined with arterial chemotherapy infusion. The postoperative clinical measures, prognosis, quality of life and complications were com-pared between the groups. Results The postoperative measures(time to get out of bed, time to bowel movement, time to oral feeding and length of hospital stay) in the study group were shorter than those in the control group, with statis-tically significant differences(P<0.05). The total rate of effectiveness with statistically significant difference [90%(43/48) vs 58%(28/48),(P<0.05)]. After surgery, the survival quality as measured by KPS scores in the two groups were increased from baseline, but the increase was significantly greater in the study group(P< 0.05). The rate of postoperative complications in the study group was 10%(5/48), slightly higher than 6%(3/48) in the control group, but the dif-ference was not statistically significant(P>0.05). At three years after surgery, the survival rate in the study group was92%(44/48), which was significantly higher than 75%(36/48) in the control group(χ^2=21.104, P=0.004). Conclusion Laparoscopic total mesorectal excision combined with arterial chemotherapy infusion is effective for treatment of mid-to-late stage rectal cancer in offering satisfactory patient safety, shorter recovery time, improved prognosis and quality of life, and therefore is worthwhile for widespread use in clinical setting
作者
何桦波
武伟
徐静芳
He Huabo;Wu Wei;Xu Jingfang(Department of Gastrointestinal,Hepatobiliary and Pancreatic Surgery,Affiliated Hospital of Hangzhou Normal University,Zhejiang 310015,China)
出处
《中国药物与临床》
CAS
2019年第10期1592-1595,共4页
Chinese Remedies & Clinics
基金
浙江省医药卫生科技计划项目(2016KYB231)
关键词
直肠肿瘤
腹腔镜直肠全系膜切除术
动脉置泵灌注化疗
生活质量
Rectal neoplasms
Laparoscopic total mesorectal excision
Arterial infusion chemotherapy
Quality of life
