CAJ | 학술논문

目的：探讨胃癌切除术后并发症的发生对患者5年生存率的影响。方法：收集2006年1月至2009年4月在我院诊断为胃腺癌且行胃癌切除术并有完整随访数据的病例380例，将其分为术后并发症组（52例）和无术后并发症组（328例），统计术后并发症的类型及分级，以分析术后并发症发生的影响因素及术后并发症的发生对患者5年生存率的影响。结果：单因素分析显示术后并发症发生的相关因素有：年龄、体质量指数（BMI）、肿瘤浸润深度、淋巴结转移、TMN分期（P＜0.05）；单因素分析显示影响患者术后5年生存率的因素有年龄、性别、肿瘤浸润深度、淋巴结转移、远处转移、TMN分期、手术方式、肿瘤分化程度、术后并发症（P＜0.05）；COX多因素分析表明术后并发症、性别、淋巴结转移数、肿瘤分化程度是影响术后5年生存率的独立因素。结论：胃癌切除术后并发症是影响患者5年生存率的独立因素之一，积极预防和治疗术后并发症对延长患者术后生存期具有重要的意义。
목적：탐토위암절제술후병발증적발생대환자5년생존솔적영향。방법：수집2006년1월지2009년4월재아원진단위위선암차행위암절제술병유완정수방수거적병례380례，장기분위술후병발증조（52례）화무술후병발증조（328례），통계술후병발증적류형급분급，이분석술후병발증발생적영향인소급술후병발증적발생대환자5년생존솔적영향。결과：단인소분석현시술후병발증발생적상관인소유：년령、체질량지수（BMI）、종류침윤심도、림파결전이、TMN분기（P＜0.05）；단인소분석현시영향환자술후5년생존솔적인소유년령、성별、종류침윤심도、림파결전이、원처전이、TMN분기、수술방식、종류분화정도、술후병발증（P＜0.05）；COX다인소분석표명술후병발증、성별、림파결전이수、종류분화정도시영향술후5년생존솔적독립인소。결론：위암절제술후병발증시영향환자5년생존솔적독립인소지일，적겁예방화치료술후병발증대연장환자술후생존기구유중요적의의。
Objective: To investigate the potential impact of postoperative complications on 5-year survival after gastrectomy for gastric cancer.Methods: A total of 380 gastric cancer patients with complete follow-up data who underwent gastrectomy between January 2006 and April 2009 in the First Afifliated Hospital of Wen-zhou Medical University were enrolled in this study. Patients were devided into 2 groups: with (n=52) or without (n=328) complications after surgery. The types and classiifcations of postoperative complications were assessed to analyze the risk factors affecting the occurrence of postoperative complications and the impact of postoperative complications on 5-year survival.Results: In the univariate analysis, age, body mass index (BMI), depth of inva-sion, lymph node metastasis, TMN staging were signiifcant predictors of postoperative complications and age, gender, depth of tumor invasion, lymph node metastasis, distant metastasis, TMN staging, surgical approach, dif-ferentiation of tumor and postoperative complications were signiifcantly related to the 5-year survival of patients (P<0.05). Mutivariate analysis based on COX proportional hazard regression model showed that postoperative complications, gender, lymph node metastasis and tumor differentiation were independent prognostic factors on 5-year survival.Conclusion: Postoperative complications after gastric resection is one of the independent factors in patients on 5-year survival, and active prevention and treatment of postoperative complications is of great sig-niifcance to prolong living time.