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目的:探讨在晚期胃癌治疗中姑息手术的临床应用价值。方法:回顾分析河北医科大学第四医院外三科行姑息性手术治疗的150例胃癌患者的临床资料,其中135例行姑息切除,将姑息手术的原因分为残留组,种植组、肝转移组及混合组。对以上病例进行随访。结果:150例患者中剖腹探查患者5例、单纯空肠造瘘和胃空肠吻合术患者10例均于10个月内死亡;姑息切除术患者135例6个月、1年、2年、3年生存率分别为62.2%、31.1%、3.7%和0;≥60岁组的中位生存期较<60岁组明显延长,P=0.013;各组生存期相比,混合组与残留组、种植组分别相比均有统计学意义,P值分别为0.000和0.001。四种姑息手术方式生存期比较无统计学意义,P=0.218。结论:晚期胃癌患者手术应慎重,尤其是对老年患者应进行详细术前检查和分期后,有选择地采取以创伤小的姑息手术为主的综合治疗手段能够延长患者的生存期。
Objective: To investigate the clinical value of palliative surgery in the treatment of advanced gastric cancer. Methods: The clinical data of 150 patients with gastric cancer undergoing palliative surgery at the Third Department of Hebei Medical University Hospital were retrospectively analyzed. Among them, 135 patients underwent palliative resection. The causes of palliative surgery were divided into residual group, implantation group, liver metastasis group And mixed group. The above cases were followed up. Results: Among 150 patients, 5 patients underwent laparotomy, and 10 patients underwent jejunostomy and gastrojejunostomy died within 10 months. 135 patients undergoing palliative resection were 6 months, 1 year, 2 years and 3 years The survival rates were 62.2%, 31.1%, 3.7% and 0 respectively. The median survival of patients ≥60 years old was significantly longer than that of <60 years old, P = 0.013. Compared with the survival time, The difference was statistically significant, P value was 0.000 and 0.001 respectively. Four kinds of palliative surgery survival was no statistical significance, P = 0.218. Conclusion: The operation of patients with advanced gastric cancer should be cautious. Especially for elderly patients, the comprehensive treatment of small palliative surgery should be taken after the detailed preoperative examination and staging, which can prolong the survival of patients.