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目的比较全胃切除术与近端胃切除术治疗胃上部癌的临床疗效。方法选取2010年1月—2012年1月光山县中医院收治的胃上部癌患者68例,随机分为观察组与对照组,各34例。观察组患者行全胃切除术治疗,对照组患者行近端胃切除术治疗。观察两组患者术前1d、术后1周血红蛋白、血清清蛋白水平、并发症(切口感染、腹腔积液、反流性食管炎)发生情况及远期生存情况。结果术前1d两组患者血红蛋白、血清清蛋白水平比较,差异无统计学意义(P>0.05),术后1周观察组患者血红蛋白、血清清蛋白水平低于对照组,差异有统计学意义(P<0.05);两组患者并发症发生率比较,差异无统计学意义(P>0.05);两组患者术后1、3年的生存率比较,差异无统计学意义(P>0.05)。结论全胃切除术与近端胃切除术治疗胃上部癌的临床疗效相当,应用时可根据患者情况选择。
Objective To compare the clinical effects of total gastrectomy and proximal gastrectomy in the treatment of upper gastric cancer. Methods Sixty-eight patients with upper gastric cancer who were admitted to Guangshan Hospital of Traditional Chinese Medicine from January 2010 to January 2012 were randomly divided into observation group and control group, with 34 cases in each group. Patients in the observation group underwent total gastrectomy, and patients in the control group underwent proximal gastrectomy. The incidence and long-term survival of hemoglobin, serum albumin, complications (incisional infection, ascitic fluid, reflux esophagitis) and hemoglobin, serum albumin level at 1 day before operation and 1 week after operation were observed in both groups. Results There was no significant difference in hemoglobin and serum albumin levels between the two groups before operation (P> 0.05). The levels of hemoglobin and serum albumin in the observation group at 1 week after operation were lower than those in the control group (P <0.05) P <0.05). There was no significant difference in complication rates between the two groups (P> 0.05). There was no significant difference in the survival rates between the two groups at 1 and 3 years after operation (P> 0.05). Conclusion Total gastrectomy and proximal gastrectomy for the treatment of upper gastric cancer have similar clinical effects, the application can be selected according to the patient’s condition.