Miles术与保肛术治疗直肠癌疗效对比.docVIP

Miles术与保肛术治疗直肠癌疗效对比 　　【摘要】目的 比较Miels术与保肛术治疗直肠癌的疗效，为临床提供参考。方法 选择我院2003年8月～2006年7月收治的直肠癌患者186例，其中对照组80例，行Miles术治疗；观察组106例，行保肛术治疗。观察并比较两组患者术后肿瘤复发率、转移率、五年生存率和生存质量的差异。结果 术后随访1年，对照组患者复发率为6.25%，远处转移率为13.75%，五年生存率为61.25%；观察组患者复发率为6.60%，远处转移率为13.21%，五年生存率为61.32%。两组患者术后肿瘤复发率、转移率和五年生存率比较，差异无统计学意义（p＞0.05）。观察组患者生存质量评分明显高于对照组，差异有统计学意义（p＜0.05）。结论 Miles术与保肛术治疗直肠癌的疗效相当，保肛术患者术后生存质量明显优于Miles术患者，在病情允许的情况下，临床应首选保肛术治疗直肠癌。 　　【关键词】Miels术 保肛术 直肠癌 临床疗效 　　中图分类号：R735.37文献标识码：A文章编号：1005-0515（2011）11-030-02 　　Miles operation and the surgical treatment of rectal cancer compared the efficacy 　　Zheng Hongwei 　　（Xinmi City General Hospital, Zheng Coal Group, Xinmi, 452 371） 　　【Abstract】Objective To compare Miels patients with rectal cancer treatment efficacy for clinical reference. Methods A hospital in August 2003 - July 2006 cancer patients admitted to 186 cases in which the control group 80 patients underwent Miles operation treatment; observation group, 106 patients underwent rectal surgery. Observe and compare the postoperative recurrence rate, metastasis rate, five-year survival rate and quality differences. Results The patients were followed up 1 year in the control group of patients relapse rate was 6.25%, distant metastasis rate was 13.75%, five-year survival rate was 61.25%; the observation group were recurrence rate was 6.60%, distant metastasis rate was 13.21%, five-year survival rate was 61.32%. Postoperative recurrence rate, metastasis rate and five-year survival rate, the difference was not statistically significant (p 0.05). The patients quality of life score was significantly higher, the difference was statistically significant (p 　　术后1年对患者进行生存质量评价，对照组患者QOL评分为（25.3±5.6）分，观察组患者QOL评分为（36.7±7.1）分，观察组???显高于对照组，差异有统计学意义（p＜0.05）。具体数据见表1。 　　表1 两组患者术后肿瘤复发率、转移率、五年生存率和QOL评分比较 　　 　　注：与对照组比较，*p＜0.05 　　3 讨论 　　在胃肠道恶性肿瘤中，直肠癌的发病率仅次于胃癌和食管癌，男性患者较女性患者多见。直肠癌的发病原因和机制目前尚未完全阐明，多数学者认为与饮食习惯和遗传因素等有关。 　　随着医学模式和人们观念的转变，治疗目的不再仅是寿命的延长，患者生存质量的提高越来越受到重视。Miles手术始创于1908年，一直以来都是临床治疗直肠癌的经典