论文部分内容阅读
目的:总结胆管癌诊治现状。方法:分析1997年5月至2001年5月上海市区常住居民中35～74岁的195例胆管癌新病例资料。结果:上、中、下段胆管癌分别占56.4%、13.4%和17.4%,联合部位者占12.8%。胆管癌明显好发于老年病人,60～74岁年龄段病人占74.9%。就诊时94.4%的病人已出现黄疸。50例行根治性切除术,术后1、2、3年生存率分别为57.1%、44.7%和26.1%。80例行姑息性引流术,1年、2年、3年生存率分别为27.5%、5.5%和1.8%。38例行胆管内支撑法治疗,平均生存时间7个月左右。经1～5年随访,全组仅9.7%(19/195)的病人存活。结论:胆管癌诊断困难,预后很差。提高疗效的措施在于:规范诊疗操作技术;积极进行手术探查;普及应用新技术;术后采用综合性治疗措施。
Objective: To summarize the diagnosis and treatment of cholangiocarcinoma. Methods: A total of 195 new cases of cholangiocarcinoma from 35 to 74 years of age in Shanghai urban area from May 1997 to May 2001 were analyzed. Results: The upper, middle and lower cholangiocarcinomas accounted for 56.4%, 13.4% and 17.4% respectively, and the combined sites accounted for 12.8%. Cholangiocarcinoma was obviously occurred in elderly patients, patients aged 60 to 74 accounted for 74.9%. At diagnosis, 94.4% of the patients had jaundice. Fifty patients underwent radical resection, and the 1, 2, 3 year survival rates were 57.1%, 44.7% and 26.1% respectively. Eighty patients underwent palliative drainage. The 1-year, 2-year and 3-year survival rates were 27.5%, 5.5% and 1.8% respectively. Thirty-eight patients underwent biliary ductal support, with an average survival of 7 months. After 1 to 5 years of follow-up, only 9.7% (19/195) of the patients in the whole group survived. Conclusion: The diagnosis of cholangiocarcinoma is difficult with poor prognosis. The measures to improve the curative effect are: to standardize the operation and treatment techniques; to actively conduct surgical exploration; to popularize the application of new technologies; and to adopt comprehensive treatment measures after the operation.