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目的:探讨大肠癌肝脏转移患者同期外科治疗的远期生存状况,为临床研究提供可参考依据。方法:选择大肠癌且发生肝脏转移的患者80例作为研究对象,患者均同期外科切除治疗。详细记录患者信息,记录患者随访3年远期生存状况,并根据随访结果分为生存组与病死组,筛选出影响患者生存状况的相关因素。结果:80例大肠癌肝转移同期外科治疗患者中有30例(37.5%)死亡。生存组转移灶最大直径为(3.21±0.90)mm,转移灶个数>4个者11例(22.0%),双叶转移10例(20.0%);分化程度Ⅲ级9例(18.0%),Ⅳ级5例(10.0%),均低于病死组的(3.56±0.82)mm、17(56.7%)、16(53.3%)、9(30.0%)、10(33.3%),差异有统计学意义(P<0.05)。多因素分析发现转移灶个数>4个、淋巴结转移、双叶肝转移、分化程度(Ⅲ~Ⅳ级)是影响大肠癌肝转移同期外科治疗生存状况的危险因素(P<0.05)。结论:转移灶个数>4个、淋巴结转移、双叶肝转移、分化程度(Ⅲ~Ⅳ级)可影响大肠癌肝转移同期外科治疗疗效,但同期外科手术切除大肠癌肝转移有较好远期生存疗效。
Objective: To investigate the long-term survival of surgical treatment of patients with liver metastasis of colorectal cancer in the same period and to provide a reference for clinical research. Methods: 80 patients with colorectal cancer and liver metastases were selected as the study subjects. All patients underwent surgical resection at the same time. The patient information was recorded in detail and the 3-year long-term survival status of the patients was recorded. According to the follow-up results, the patients were divided into survival group and death group, and the factors influencing the survival status of patients were screened out. Results: Thirty (37.5%) of the 80 patients with surgical resection of liver metastasis of colorectal cancer died. (3.21 ± 0.90) mm in the survival group, 11 cases (22.0%) in the metastasis> 4 cases, 10 cases (20.0%) in the double leaf metastasis, 9 cases (18.0% (3.56 ± 0.82) mm, 17 (56.7%), 16 (53.3%), 9 (30.0%) and 10 (33.3%) in grade Ⅳ and grade Ⅳ respectively. The difference was statistically significant Significance (P <0.05). Multivariate analysis found that the number of metastases> 4, lymph node metastasis, bile leaf liver metastasis, degree of differentiation (grade Ⅲ ~ Ⅳ) were the risk factors for survival of patients with colorectal cancer during liver transplantation (P <0.05). Conclusion: The number of metastases> 4, lymph node metastasis, bileumatic liver metastasis, degree of differentiation (Ⅲ ~ Ⅳ grade) may affect the surgical treatment of colorectal cancer with liver metastases over the same period, but the surgical removal of colorectal liver metastases over the same period is far better Survival efficacy.