老年进展期胰腺癌98例临床的研究.docVIP

老年进展期胰腺癌98例临床研究 　　作者：姜青峰 薛涣洲 申权 张业伟 作者单位：450003河南省郑州市，河南省人民医院肝胆胰腺外科(姜青峰，薛涣洲，申权);210029江苏省南京市，南京医科大学第一附属医院肝脏外科(张业伟) 　　【摘要】 目的 探讨进展期胰腺癌不同的治疗方法对预后的影响，以达到治疗的最优化。 方法 回顾性分析2002年11月至2005年9月收治的98例进展期胰腺癌，分为手术组(81例)：手术[行胆系和(或)肠系转流术、活检术等]加或不加辅助治疗;非手术组(17例)：行非手术治疗;并分析其治疗效果。 结果 手术组并发症发生率为17.3%(14/81)、病死率为4.9%(4/81)，生存期平均为(2.9±2.3)年，加或不加辅助治疗其生存期分别为(2.9±3.7)年、(2.8±3.1)年;非手术组无并发症和死亡，生存期平均(2.7±2.1)年。 结论 对进展期无法行根治性切除术的胰腺癌、姑息性切除是无益的，对伴发胆系和(或)肠系梗阻时行转流术是必须的，围手术期辅助治疗是改善预后的重要方法。 　　【关键词】 进展期胰腺癌; 手术治疗; 非手术治疗; 辅助治疗 　　Clinical research of advanced pancreatic carcinoma in 98 elderly patients 　　JIANG Qingfeng, XUE Huanzhou, SHEN Quan.Department of HepatoPancreatoBiliary Surgery，Henan Province Peoples Hospital,Zhengzhou 450003,China; ZHANG Yewei.Department of Hepatobiliary Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210009, China 　　【Abstract】　Objective To evaluate the effects of different treatment methods on advanced pancreatic carcinoma in elderly patients in order to optimize the curative scheme. Methods Nintyeight cases with advanced pancreatic carcinoma from Nov. 2002 to Sep. 2005 were divided into two groups：operation group (81 cases including the bypass of biliary and/or intestine, biopsy) with or without the adjuvant treatment, and nonoperation group(17 cases). Therapeutic efficacy in each group was evaluated. Results The complication rate and mortality were 17.3% and 4.9% respectively in operation group, and the mean life span was 2.9±2.3 years, with 2.9±3.7 years in patients who received adjuvant treatment and 2.8±3.1 years in patients with no adjuvant treatment. No complication and death happened in nonoperation group, and the mean life span was 2.7±2.1 years. Conclusions The palliative resection is futile for advanced pancreatic carcinoma impossible to radical excision. The bypass operation is imperative for biliary duct and/or intestine obstruction. The adjuvant treatment is an important method to improve prognosis.