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目的观察并比较D1和D2淋巴结清扫术治疗胃癌的临床疗效及术后并发症发生情况。方法选取2007年1月至2010年1月收治的60例胃癌患者为研究对象,根据治疗方式的不同分为两组,D1组患者采用D1淋巴结清扫术进行治疗,D2组患者采用D2淋巴结清扫术进行治疗,比较两组患者1、3、5年的生存率,以及两组术后并发症发生情况。结果 D1、D2组患者1、3、5年的生存率[86.7%vs 93.3%(χ2=0.72,P>0.05)、56.7%vs 70.0%(χ2=1.12,P>0.05)、40.0%vs 53.3%(χ2=1.05,P>0.05)],差异均无统计学意义。D1组患者术后吻合口瘘、胰瘘、切口感染、肺部感染等并发症发生率明显高于D2组患者,差异均具有统计学意义(χ2=5.10,6.29,7.08,9.16;P<0.05或P<0.01)。结论 D1和D2淋巴结清扫术治疗胃癌的临床疗效均较好,但D2淋巴结清扫术术后并发症少,能提高患者的生存质量。
Objective To observe and compare the clinical efficacy of D1 and D2 lymph node dissection in the treatment of gastric cancer and the incidence of postoperative complications. Methods Sixty patients with gastric cancer admitted to our hospital from January 2007 to January 2010 were divided into two groups according to the different treatment methods. Patients in group D1 were treated with D1 lymph node dissection. Patients in group D2 received D2 lymph node dissection After treatment, the survival rates of one, three, and five years in both groups were compared, and the incidence of postoperative complications was compared between the two groups. Results The survival rates at 1, 3 and 5 years in patients with D1 and D2 were 86.7% vs 93.3% (χ2 = 0.72, P> 0.05), 56.7% vs 70.0% (χ2 = 1.12, P> 0.05) % (χ2 = 1.05, P> 0.05)], the difference was not statistically significant. The incidence of complications such as anastomotic fistula, pancreatic fistula, incision infection and pulmonary infection in group D1 was significantly higher than that in group D2 (χ2 = 5.10,6.29,7.08,9.16; P <0.05 Or P <0.01). Conclusion The clinical curative effect of D1 and D2 lymph node dissection in treating gastric cancer are good, but D2 lymph node dissection less complications, can improve the quality of life of patients.