实用癌症杂志
實用癌癥雜誌
실용암증잡지
THE PRACTICAL JOURNAL OF CANCER
2015年
6期
856-859
,共4页
新辅助化疗%腹腔镜手术%直肠癌%疗效
新輔助化療%腹腔鏡手術%直腸癌%療效
신보조화료%복강경수술%직장암%료효
Neoadjuvant chemotherapy%Laparoscopic operation%Colorectal cancer%Efficacy
目的：探讨新辅助化疗联合腹腔镜手术治疗直肠癌的临床疗效。方法选取直肠癌患者104例，随机分为观察组和对照组各52例。两组患者均给予腹腔镜直肠癌切除术治疗，观察组在术前采用 FOLFOX4化疗方案给予4个周期的化疗，术后继续行8个周期的化疗。对照组则在术后给予12个周期的化疗。对比两组患者手术前后癌胚抗原（CEA）和糖类抗原199（CA199）的变化情况、手术时间、术中出血量、术后肛门首次排气时间、术后住院天数以及术后并发症的发生情况。结果两组患者的手术时间、术中出血量、术后肛门首次排气时间和术后首次下床活动时间比较，差异均无统计学意义（P ＞0．05）；观察组术后并发症发生率为7．69％，对照组为9．62％，两组比较，差异无统计学意义（P＞0．05）；观察组术后3个月 CEA 转阴率为69．44％，CA199的转阴率为68．00％，均显著高于对照组（P ＜0．05）；观察组术后无疾病进展生存期为（11．31±1．03）个月，中位生存期为（32．04±2．13）个月，均显著长于对照组（P ＜0．05）。结论新辅助化疗联合腹腔镜手术有助于提高直肠癌的临床疗效，改善患者的预后，且不增加手术风险，安全性好。
目的：探討新輔助化療聯閤腹腔鏡手術治療直腸癌的臨床療效。方法選取直腸癌患者104例，隨機分為觀察組和對照組各52例。兩組患者均給予腹腔鏡直腸癌切除術治療，觀察組在術前採用 FOLFOX4化療方案給予4箇週期的化療，術後繼續行8箇週期的化療。對照組則在術後給予12箇週期的化療。對比兩組患者手術前後癌胚抗原（CEA）和糖類抗原199（CA199）的變化情況、手術時間、術中齣血量、術後肛門首次排氣時間、術後住院天數以及術後併髮癥的髮生情況。結果兩組患者的手術時間、術中齣血量、術後肛門首次排氣時間和術後首次下床活動時間比較，差異均無統計學意義（P ＞0．05）；觀察組術後併髮癥髮生率為7．69％，對照組為9．62％，兩組比較，差異無統計學意義（P＞0．05）；觀察組術後3箇月 CEA 轉陰率為69．44％，CA199的轉陰率為68．00％，均顯著高于對照組（P ＜0．05）；觀察組術後無疾病進展生存期為（11．31±1．03）箇月，中位生存期為（32．04±2．13）箇月，均顯著長于對照組（P ＜0．05）。結論新輔助化療聯閤腹腔鏡手術有助于提高直腸癌的臨床療效，改善患者的預後，且不增加手術風險，安全性好。
목적：탐토신보조화료연합복강경수술치료직장암적림상료효。방법선취직장암환자104례，수궤분위관찰조화대조조각52례。량조환자균급여복강경직장암절제술치료，관찰조재술전채용 FOLFOX4화료방안급여4개주기적화료，술후계속행8개주기적화료。대조조칙재술후급여12개주기적화료。대비량조환자수술전후암배항원（CEA）화당류항원199（CA199）적변화정황、수술시간、술중출혈량、술후항문수차배기시간、술후주원천수이급술후병발증적발생정황。결과량조환자적수술시간、술중출혈량、술후항문수차배기시간화술후수차하상활동시간비교，차이균무통계학의의（P ＞0．05）；관찰조술후병발증발생솔위7．69％，대조조위9．62％，량조비교，차이무통계학의의（P＞0．05）；관찰조술후3개월 CEA 전음솔위69．44％，CA199적전음솔위68．00％，균현저고우대조조（P ＜0．05）；관찰조술후무질병진전생존기위（11．31±1．03）개월，중위생존기위（32．04±2．13）개월，균현저장우대조조（P ＜0．05）。결론신보조화료연합복강경수술유조우제고직장암적림상료효，개선환자적예후，차불증가수술풍험，안전성호。
Objective To investigate the clinical efficacy of neoadjuvant chemotherapy combined with laparoscopic oper -ation in the treatment of colorectal cancer .Methods 104 patients with colorectal cancer were randomly divided into the observa -tion group and the control group ,each with 52 cases.Both groups were given laparoscopic resection for colorectal cancer ,the ob-servation group received 4 cycles of FOLFOX4 chemotherapy before operation ,and 8 cycles of chemotherapy after operation .The control group received 12 cycles of chemotherapy after operation .Carcinoembryonic antigen (CEA)and carbohydrate antigen 199 (CA199)changes,operation time,intraoperative bleeding volume ,postoperative anal exhaust time ,postoperative hospital stay and postoperative complications of the 2 groups before and after operation were compared .Results There had no statistically signifi-cant differences between the 2 groups in operation time,intraoperative bleeding volume,postoperative anal exhaust time and post -operative first ambulation time(P >0.05);postoperative complications rates in the observation group and the control group were 7.69% and 9.62%,the difference was not statistically significant (P >0.05);3 months after operation,CEA and CA199 negative rates in the observation group were 69.44% and 68.00%,which were significantly higher than those of the control group (all P <0.05);in the observation group,progression-free survival was(11.31 ±1.03)months,median survival time was(32.04 ±2.13) months,which were significantly longer than those of the control group (P <0.05).Conclusion Neoadjuvant chemotherapy com -bined with laparoscopic operation can improve the clinical efficacy of colorectal cancer ,improve the prognosis of the patients with -out increase the risk of operation,and it has good safety.
