摘要
目的探讨单纯性梗阻性左半结肠癌接受根治性手术患者预后状况的影响因素。方法回顾性分析如皋市人民医院2015年2月-2017年6月接诊的186例单纯性梗阻性左半结肠癌患者。按照手术方式不同分为2组,其中行一期切除吻合术的140例,行二期切除吻合术的46例。观察患者的性别、年龄、肿瘤分化情况和位置、梗阻到手术时间、临床分期、手术方式以及术后是否化疗等与患者的累积生存率之间的关系,并分别采取单因素和多因素分析患者的预后生存情况。结果患者术后并发症的总发生率为20.96%,患者的累积生存率随时间的推移而下降。单因素分析结果显示,患者的性别、年龄、肿瘤位置与预后无关(P>0.05),病理类型、临床分期、手术方式以及术后是否化疗与预后有关(P<0.05)。多因素分析结果显示,Dukes分期、肿瘤分化以及术后化疗对患者生存率影响较小(P>0.05),手术方式能够提高患者的生存率(P<0.05)。结论病理类型、临床分期、手术方式、Dukes分期、肿瘤分化以及术后化疗为影响单纯性梗阻性左半结肠癌预后的因素。
Objective To investigate the factors that affect the prognosis of patients with simple obstructive left colon cancer after radical operation. Methods The clinical data on 186 cases of simple obstructive left colon cancer treated in our hospital between February 2012 and June 2013 was retrospectively analyzed.According to surgical approaches, these patients were divided into two groups: the primary resection and anastomosis group(n=140) and the two-stage resection and anastomosis group(n=46). The correlations between cumulative survival rate and sex, age, tumor differentiation and location, duration of obstruction until operation, clinical stages, surgical methods and postoperative chemotherapy were observed. The prognosis and survival of the patients were analyzed via univariate and multivariate analysis. Results The total incidence of postoperative complications was(20.96%), and the cumulative survival rate of the patients decreased with time.Univariate analysis showed that gender, age and tumor locations were not related to prognosis(P>0.05),while pathological types, clinical stages, surgical approaches and postoperative chemotherapy were correlated with prognosis(P<0.05).Multivariate analysis showed that Dukes stage, tumor differentiation and postoperative chemotherapy had little effect on the survival rate of patients(P>0.05), while the surgical approach could significantly improve the survival rate of patients(P<0.05). Conclusion It is feasible to treat patients with simple obstructive left colon cancer with radical surgery, which can improve the prognosis and life quality of patients.
作者
顾吉宏
刘海露
许盈波
史发兰
GU Jihong;LIU Hailu;XU Yingbo;SHI Falan(Department of General Surgery,Rugao People's Hospital,Rugao Jiangsu226500,China)
出处
《空军医学杂志》
2020年第2期130-132,149,共4页
Medical Journal of Air Force
关键词
梗阻性
左半结肠癌
根治术
预后
obstructive
left colon cancer
radical mastectomy
prognosis
