CAJ | 학술논문

目的探讨代谢综合征(MS)在胃癌患者中的发病率,分析MS与胃癌发生部位的关系,并研究MS对手术操作和胃癌患者术后短期疗效的影响.方法回顾性分析2006年1月至2008年6月青岛大学医学院附属医院手术治疗639例胃癌患者的临床资料,将合并MS的64例患者设为MS组,无MS的575例患者设为对照组,统计手术和术后并发症发生情况,比较两组患者肿瘤部位、术中情况和术后短期疗效.采用χ2检验及t检验对检测结果进行分析.结果 MS在胃癌患者中的发病率为10.0%(64/639),其中男性胃癌患者MS发病率为8.2%(37/451),女性患者为14.4%(27/188),两者比较,差异有统计学意义(χ2=6.265,P<0.05).MS组患者的手术时间为(185±133)min,显著长于对照组的(168±50)min(t=2.126,P<0.05);MS组患者的淋巴结清扫数目为(18±11)枚,显著少于对照组的(21±11)枚(t=2.125,P<0.05);MS组患者术后发热时间为(3.0±1.4)d,显著长于对照组的(2.5±1.4)d(t=2.433,P<0.05);MS组患者术后并发症发生率为31.3%(20/64),显著高于对照组的14.3%(82/575)(χ2=12.291,P<0.05).MS组患者住院时间为(19±11)d,显著长于对照组的(16±11)d(t=2.141,P<0.05).MS组病死率为0,对照组为0.5%(3/575),两组比较,差异无统计学意义(χ2=0.000,P>0.05).结论胃癌患者的MS发病率较低.合并MS的胃癌患者手术时间长、淋巴结清扫数目少、术后并发症发生率较高,住院时间及住院费用相应增加.应加强合并MS的胃癌患者围手术期的处理.
목적 탐토대사종합정(MS)재위암환자중적발병솔,분석MS여위암발생부위적관계,병연구MS대수술조작화위암환자술후단기료효적영향.방법 회고성분석2006년1월지2008년6월청도대학의학원부속의원수술치료639례위암환자적림상자료,장합병MS적64례환자설위MS조,무MS적575례환자설위대조조,통계수술화술후병발증발생정황,비교량조환자종류부위、술중정황화술후단기료효.채용χ2검험급t검험대검측결과진행분석.결과 MS재위암환자중적발병솔위10.0%(64/639),기중남성위암환자MS발병솔위8.2%(37/451),녀성환자위14.4%(27/188),량자비교,차이유통계학의의(χ2=6.265,P<0.05).MS조환자적수술시간위(185±133)min,현저장우대조조적(168±50)min(t=2.126,P<0.05);MS조환자적림파결청소수목위(18±11)매,현저소우대조조적(21±11)매(t=2.125,P<0.05);MS조환자술후발열시간위(3.0±1.4)d,현저장우대조조적(2.5±1.4)d(t=2.433,P<0.05);MS조환자술후병발증발생솔위31.3%(20/64),현저고우대조조적14.3%(82/575)(χ2=12.291,P<0.05).MS조환자주원시간위(19±11)d,현저장우대조조적(16±11)d(t=2.141,P<0.05).MS조병사솔위0,대조조위0.5%(3/575),량조비교,차이무통계학의의(χ2=0.000,P>0.05).결론 위암환자적MS발병솔교저.합병MS적위암환자수술시간장、림파결청소수목소、술후병발증발생솔교고,주원시간급주원비용상응증가.응가강합병MS적위암환자위수술기적처리.
Objective To investigate the incidence of metabolic syndrome (MS) in patients with gastric cancer, and to explore the relationship between MS and the tumor site and the influence of MS on surgical procedure and short-term outcomes of patients with gastric cancer. Methods The clinical data of 639 patients with gastric cancer who were admitted to the Affiliated Hospital of Qingdao University from January 2006 to June 2008 were retrospectively analyzed. Patients with MS were in the MS group ( n= 64) and those without MS were in the control group ( n = 575 ). The surgical and postoperative complications were reviewed and the tumor site, intraoperative conditions and short-term outcomes between the two groups were analyzed. All data were analyzed using the chi-square test or t test. Results The incidence of MS in patients with gastric cancer was 10.0% (64/639).The incidence of MS in female patients was 14.4% (27/188), which was significantly higher than 8.2% (37/451)of male patients ( χ2= 6.265, P < 0.05). The operation time of the MS group was ( 185 ± 133 ) minutes, which was significantly longer than ( 168 ± 50) minutes of the control group ( t = 2. 126, P < 0. 05 ). The number of lymph nodes dissected in the MS group was 18 ± 11, which was significantly lower than 21 ± 11 of the control group ( t = 2. 125, P < 0.05 ). The postoperative period of fever of the MS group was (3.0 ± 1.4) days, which was significantly longer than (2.5 ± 1.4) days of the control group (t = 2. 433, P < 0.05 ). The incidence of postoperative complications of the MS group was 31.3% (20/64), which was significantly higher than 14.3% (82/575) of the control group ( χ2 = 12.291, P < 0.05 ). The length of hospital stay of the MS group was ( 19 ± 11 ) days,which was significantly longer than ( 16±11 ) days of the control group ( t = 2. 141, P< 0.05 ). The mortalities of MS group and control group were 0 and 0. 5% (3/575), respectively, with no significant difference ( χ2 = 0.000,P >0.05). Condusions A low prevalence of MS is found in patients with gastric cancer. However, patients with gastric cancer complicated with MS may present with prolonged surgical procedure, reduced amount of lymph nodes dissected and increased incidence of postoperative complications, hospital stay and costs. Perioperative management of patients with gastric cancer complicated with MS should be paid more attention.