肝门部胆管癌47例临床分析.docVIP

肝门部胆管癌47例临床分析 　　[摘要] 目的 探讨肝门部胆管癌的不同治疗方法的效果。 方法 回顾性分析2012年1月～2013年9月在我院治疗的47例肝门部胆管癌的临床资料。 结果 47例中根治性手术切除11例，姑息性切除16例，单纯引流20例。根治组平均生存时间为14.5个月，6、12、18个月生存率分别为90.9%、72.7%、54.5%。姑息组中位生存时间为9.1个月，6、12、18个月生存率分别为81.3%、43.8%、25.0%。引流组中位生存时间为5.8个月，6、12、18个月生存率分别为50.0%、25.0%，10.0%。3组的中位生存期差异有统计学意义（P0.05）。 结论 根治性切除是治疗肝门部胆管癌最有效的方法，而联合肝叶的切除及区域淋巴结的清扫可以提高其根治性切除率。对于晚期没有根治机会的患者，也应积极地姑息切除，对无法手术切除的患者要积极通畅引流，以缓解症状，提高患者的生活质量，延长其生命。 　　[关键词] 肝门部胆管癌；治疗方法；效果；生存率 　　[中图分类号] R735.8 [文献标识码] A [文章编号] 1674-4721（2015）09（b）-0061-04 　　Clinical analysis of 47 cases for hilar cholangiocarcinoma 　　NING Jia-yong1 HE Jie-feng2 ZHAO Hao-liang2▲ 　　1.Shanxi Medical University，Taiyuan 030001，China；2.Department of General Surgery，Shanxi Dayi Hospital，Shanxi Academy of Medical Sciences，Taiyuan 030000，China 　　[Abstract] Objective To explore the effect of different therapy in the treatment of hilar cholangiocarcinoma （HCC）. Methods The data of the 47 patients with HCC treated in our hospital from January 2012 and September 2013 was analyzed retrospectively. Results Among 47 patients，11 cases for radical resection，16 cases for palliative resection and 20 received simple drainage.The average survival time for radical resection group was 14.5 months，and 6 months，12 months， 18 months survival rate was 90.0%，72.7% and 54.5% respectively.The media survival time for palliative resection group was 9.1 months，and the 6 months，12 months，18 months survival rate was 81.3%，43.8% and 25.0% respectively.The media survival time for simple drainage was 5.8 months，and the 6 months，12 months，18 months survival rate was 50.0%，25.0% and 10.0% respectively.Significant difference was found among three groups （P0.05）. Conclusion Radical resection is the most effective treating HCC，and extend resection of liver lobes and lymph node can improve the radical resection rate.For patients who has no chance for radical resection，palliative resection should be selected，and positive and open drainage should be done for patients who ha