CAJ | 학술논문

目的：了解某三级甲等医院肝外胆管癌手术患者的住院情况,为改善患者体验和加强院内管理提供现实依据。方法回顾性分析2005年至2014年收治的445例行手术治疗的肝外胆管癌患者临床资料,综合统计其性别、年龄、病理类型、手术方式、治疗结果、住院天数及费用等数据资料。结果445例行手术治疗的肝外胆管癌中男271例(60.90%),女174例(39.10%),男女比例为1.56︰1。患者年龄21~93岁,平均(59.7±13.83)岁,50~80岁所占比例较大(393例,88.31%),其中>50~60岁140例(31.46%),>60~70岁132例(29.67%),>70~<80岁121例(27.19%)。病理类型以腺癌最为多见(90.3%),炎症癌变和印戒细胞癌治愈率最高(100.0%)。肝门部胆管癌根治术在胆管上段癌手术方式中的平均构成比为11.23%；胰十二指肠切除术在胆管中下段癌手术方式中的平均构成比为20.64%。胆管上部癌术前住院日为(11.16±6.12) d,术后(21.16±11.23) d,平均住院日为(33.35±10.11) d；平均住院费用为(56852.54±21325.32)元,药费占总费用平均比例为(40.21±7.11)%；胆管中下部癌术前住院日为(10.29±9.77) d,术后(20.27±8.26) d,平均住院日为(30.56±11.23) d；平均住院费用为(73401.76±42816.24)元,药费占总费用平均比例为(40.86±9.23)%。结论中老年男性应警惕肝外胆管癌的发生。某院肝外胆管癌治疗效果逐年提高,住院时间逐渐减少,住院费用增长较为合理。
목적：료해모삼급갑등의원간외담관암수술환자적주원정황,위개선환자체험화가강원내관리제공현실의거。방법회고성분석2005년지2014년수치적445례행수술치료적간외담관암환자림상자료,종합통계기성별、년령、병리류형、수술방식、치료결과、주원천수급비용등수거자료。결과445례행수술치료적간외담관암중남271례(60.90%),녀174례(39.10%),남녀비례위1.56︰1。환자년령21~93세,평균(59.7±13.83)세,50~80세소점비례교대(393례,88.31%),기중>50~60세140례(31.46%),>60~70세132례(29.67%),>70~<80세121례(27.19%)。병리류형이선암최위다견(90.3%),염증암변화인계세포암치유솔최고(100.0%)。간문부담관암근치술재담관상단암수술방식중적평균구성비위11.23%；이십이지장절제술재담관중하단암수술방식중적평균구성비위20.64%。담관상부암술전주원일위(11.16±6.12) d,술후(21.16±11.23) d,평균주원일위(33.35±10.11) d；평균주원비용위(56852.54±21325.32)원,약비점총비용평균비례위(40.21±7.11)%；담관중하부암술전주원일위(10.29±9.77) d,술후(20.27±8.26) d,평균주원일위(30.56±11.23) d；평균주원비용위(73401.76±42816.24)원,약비점총비용평균비례위(40.86±9.23)%。결론중노년남성응경척간외담관암적발생。모원간외담관암치료효과축년제고,주원시간축점감소,주원비용증장교위합리。
Objective To investigate the hospitalization of extra-hepatic cholangiocarcinoma patients undergoing surgeries, and to provide information for improving patients’ feeling and strengthening hospital management. Methods An investigation was conducted by means of the retrospective survey. The data of patients suffering from cholangiocarcinoma in a tertiary hospital in Guangzhou from 2005 to 2014 was collected, including gender, age, pathological type, treatment results, hospitalization days and costs and so on. Results The number of male cases was 271(60.9%), and female cases was 174 (39.1%), the ratio of male: female was 1.56︰1. The age range was from 21-93 years old, and the average age was (59.7±13.83), including 140 cases of >50-60 years old (31.46%), 132 cases of>60-70 (29.67%), 121 cases of>70-<80 (27.19%). The main histological type was adenocarcinoma (90.3%), and the cure rates of inflammatory carcinoma and signet ring cell carcinoma were the highest(100.0%). The main mangement of cholangiocarcinoma was radical resection,with the cure rate of surgery 40.22% during the 10 years. For upper cholangiocarcinoma, hospitalization stay before and after operation were respectively (11.16±6.12)days and (21.16±11.23) days, with an average of (33.35± 10.11) days. Average hospitalization cost was (56 852.54±21 325.32) yuan and proportion of drug fees up to (40.86±9.23)%. While for middle and lower cholangiocarcinoma,the respective hospitalization stay were (10.29 ±9.77) days and (20.27 ±8.26)days, average hospital stay was (30.56±11.23) days, hospitalization cost (73 401.76±42 816.24) yuan, and proportion of drug fees (40.86±9.23)%. Conclusion Middle aged males should be aware of cholangiocarcinoma. Curative effect for cholangiocarcinoma improves year by year in this hospital, and the increase of hospitalization expenses is reasonable.