中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2010年
8期
598-600
,共3页
恶性肿瘤%胃出口梗阻%支架%生活质量
噁性腫瘤%胃齣口梗阻%支架%生活質量
악성종류%위출구경조%지가%생활질량
Malignant neoplasms%Gastric outlet obstruction%Stent%Quality of life
目的 探讨恶性胃出口梗阻(GOO)患者的治疗选择.方法 对39例继发于不可切除的原发性或转移性消化系统肿瘤的GOO患者分别予以内镜下支架置入术(支架组,13例)、胃旁路手术(旁路组,21例)和经皮胃造口术(造口组,5例),分别于术前、术后1、3个月采用QLQ-STO22表进行生活质量(QOL)评估.结果 本组39例患者术后中位生存时间是68 d,其中支架组(85 d)和旁路组(72 d)的中位生存时间明显长于造口组的48 d(P<0.05);但支架组与旁路组比较生存时间的差异无统计学意义(P>0.05).本组共有14例患者(支架组和旁路组各7例)在治疗前、治疗后1个月和3个月均完成了QOL调查,支架组患者吞咽困难、饮食限制、舌干及反流症状均得到明显改善(P<0.05);旁路组患者吞咽困难和饮食限制得到明显改善(P<0.05),但舌干、反流及疼痛症状则无明显改善(P>0.05).结论 尽管恶性GOO患者预后很差,旁路手术和内镜下支架置入术仍然能有效缓解恶性GOO患者的症状,可作为积极的治疗选择.
目的 探討噁性胃齣口梗阻(GOO)患者的治療選擇.方法 對39例繼髮于不可切除的原髮性或轉移性消化繫統腫瘤的GOO患者分彆予以內鏡下支架置入術(支架組,13例)、胃徬路手術(徬路組,21例)和經皮胃造口術(造口組,5例),分彆于術前、術後1、3箇月採用QLQ-STO22錶進行生活質量(QOL)評估.結果 本組39例患者術後中位生存時間是68 d,其中支架組(85 d)和徬路組(72 d)的中位生存時間明顯長于造口組的48 d(P<0.05);但支架組與徬路組比較生存時間的差異無統計學意義(P>0.05).本組共有14例患者(支架組和徬路組各7例)在治療前、治療後1箇月和3箇月均完成瞭QOL調查,支架組患者吞嚥睏難、飲食限製、舌榦及反流癥狀均得到明顯改善(P<0.05);徬路組患者吞嚥睏難和飲食限製得到明顯改善(P<0.05),但舌榦、反流及疼痛癥狀則無明顯改善(P>0.05).結論 儘管噁性GOO患者預後很差,徬路手術和內鏡下支架置入術仍然能有效緩解噁性GOO患者的癥狀,可作為積極的治療選擇.
목적 탐토악성위출구경조(GOO)환자적치료선택.방법 대39례계발우불가절제적원발성혹전이성소화계통종류적GOO환자분별여이내경하지가치입술(지가조,13례)、위방로수술(방로조,21례)화경피위조구술(조구조,5례),분별우술전、술후1、3개월채용QLQ-STO22표진행생활질량(QOL)평고.결과 본조39례환자술후중위생존시간시68 d,기중지가조(85 d)화방로조(72 d)적중위생존시간명현장우조구조적48 d(P<0.05);단지가조여방로조비교생존시간적차이무통계학의의(P>0.05).본조공유14례환자(지가조화방로조각7례)재치료전、치료후1개월화3개월균완성료QOL조사,지가조환자탄인곤난、음식한제、설간급반류증상균득도명현개선(P<0.05);방로조환자탄인곤난화음식한제득도명현개선(P<0.05),단설간、반류급동통증상칙무명현개선(P>0.05).결론 진관악성GOO환자예후흔차,방로수술화내경하지가치입술잉연능유효완해악성GOO환자적증상,가작위적겁적치료선택.
Objective To evaluate outcomes after different treatment options including endoscopic stent placement,surgical bypass,and percutaneous gastrostomy for malignant gastric outlet obstruction(GOO).Methods Thirty-nine patients with GOO secondary to unresectable primary ormetastatic cancer were treated with endoscopic stent placement(group 1,n=13),surgical bypass(group 2,n=21),or percutaneous gastrostomy(group 3,n=5).QLQ-STO22 form was used to assess quality of life(QOL)at baseline,1 month,and 3 months following intervention.Results Overall median survival time was 68 days.Median survival time in group 1 and group 2 was 85 and 72 days respectively,longer than that in group 3(48 days,P<0.05).Fourteen patients(7 cases in group 1 and 7 cases in group 2) completed all three QOL surveys.All the patients in group 1 had significant improvement in dysphagia,dietary restrictions,dry mouth,and reflux(P<0.05).In group 2,dysphagia and dietary restrictions were significantly improved(P<0.05),while there were no significant improvements in dry mouth,reflux and pain(all P>0.05).Conclusion Although the prognosis of malignant GOO is poor,endoscopic stent placement and surgical bypass may improve QOL of pafients and therefore are reasonable alternatives for palliation.
