经左胸腔和经腹贲门癌手术的临床对比分析.docVIP

经左胸腔和经腹贲门癌手术的临床对比分析 　　作者：何玉华,程飞,丁云礼　　作者单位：安庆市第一人民医院心胸外科 　　【摘要】目的探讨经左胸腔及经腹贲门癌手术优缺点。方法回顾性分析164例贲门癌患者的临床资料，根据手术路径不同将患者随机分为两组，比较两组患者的疗效差异。结果 两组患者的吻合口瘘、切口感染及围手术期死亡的发生几率之间，差异无统计学意义(P0.05);但经左胸腔切口组患者的肺部感染的发生几率明显高于经腹切口组，差异有统计学意义(P0.05)。经左胸腔切口组平均清扫淋巴结数为10.9枚，与经腹切口组16.2枚比较，差异有统计学意义(P0.05);但两组患者的1年生存率及3年生存率比较分析，差异无统计学意义(P0.05)。结论 临床上要根据患者的具体情况和病变部位选择合适的手术路径，以便于彻底根治肿瘤，减少术后并发症，延长患者的生存时间。 　　【关键词】 经左胸腔切口,经腹切口,贲门癌 　　[Abstract] Objective To discuss the Ieft thoracotomy and upper abdomina of Lardiac carcinoma surgery good and bad points. Methods Retrospective analysis of the clinical data of 164 cases of carcinoma of gastric cardia.which my courtyard admitted in recent years, divided into stochastically differently according to the surgery way the patient 2 groups, compared with 2 group of patients curative effect differences.Results Two group of patients lips heals leak, the margin infection and encircle the surgery time death between the occurrence probability, not obvious difference(P0.05);But passes through the occurrence probability which the Ieft thoracotomy group patients lungs infect to be higher than obviously after the upper abdomina group, has the significance difference(P0.05).After the l Ieft thoracotomy group average cleaning lymph total is 10.9, with compares after abdomen margin group 16.2, the difference has the significance(P0.05);But two group of patients 1 year survival rate and 3 year survival rate comparative analysis, non-significance difference(P0.05).Conclusion On clinical must act according to patients special details and the pathological change spot choice appropriate surgery way, is advantageous for the thorough permanent control tumor, after reducing the technique the complication, lengthens patients life. 　　[Key words] Ieft thoracotomy; Upper abdomina;Lardiac carcinoma 　　贲门癌是消化道常见的恶性肿瘤，因其解剖部位特殊，发生于食管胃交界处，发病隐匿，就诊时通常已处于中、晚期[1]。因此，手术是其首选的治疗方案，但关于手术路径的合理选择一直是临床上关于贲门癌手术争议的主要问题。为了探讨经左胸及经腹贲门癌手术优缺点，现将我院近年来收治的164例贲门癌患者的临床资料分析总结如下。 　　1 资料与