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目的本研究对胃癌患者的临床病理特征和影响预后的多种因素进行分析,以提高对胃癌的认识和治疗水平。方法根据患者的住院时间将南京医科大学第一附属医院1994年至2003年间收治的1451例胃癌患者分为两组(组1为1994年至1998年,组2为1999年至2003年),对他们的临床病理特点和手术预后采用Wilcoxon秩和检验进行统计学比较,生命表法进行生存率分析,采用Cox模型进行多因素分析,评价影响胃癌术后生存的独立危险因素。结果两组胃癌患者中,患者的数量正逐年增加,早期胃癌的诊断率和淋巴结转移率明显提高,位于上部胃的肿瘤从20.6%增加到36.83%。手术相关并发症从5.23%降低到1.43%,组1和组2的手术死亡率分别为0.49%和0.24%,5年生存率分别为38.4%和53.99%。结论早期诊断、规范的手术治疗,标准的淋巴结清扫和围手术期优质护理可以提高胃癌患者的生存率。
Objective This study analyzed the clinical and pathological features of gastric cancer patients and the prognosis of a variety of factors to improve awareness and treatment of gastric cancer. Methods According to the length of hospital stay, 1,451 patients with gastric cancer admitted to the First Affiliated Hospital of Nanjing Medical University from 1994 to 2003 were divided into two groups (Group 1 from 1994 to 1998 and Group 2 from 1999 to 2003) Their clinical and pathological features and prognosis of surgery were compared using Wilcoxon rank sum test. The survival rate was analyzed by life table method. Cox model was used to analyze multivariate analysis to evaluate the independent risk factors of postoperative survival. Results The number of patients in two groups of gastric cancer was increasing year by year. The diagnosis rate and lymph node metastasis rate of early gastric cancer were significantly increased. The tumors located in the upper stomach increased from 20.6% to 36.83%. The complications related to surgery decreased from 5.23% to 1.43%. The mortality rates in group 1 and group 2 were 0.49% and 0.24%, respectively. The 5-year survival rates were 38.4% and 53.99% respectively. Conclusion Early diagnosis, standard surgical treatment, standard lymph node dissection and perioperative quality nursing can improve the survival rate of gastric cancer patients.