CAJ | 학술논문

目的：探讨全直肠系膜切除手术（ TME）对直肠癌患者近远期疗效及生存质量的影响。方法将2007年1月至2009年12月收治的150例中低位直肠癌患者根据患者术式分为TME组84例及传统手术组66例，对两组患者随访5年，对比分析两组患者近远期疗效及生存质量。采用SPSS17．0统计学数据软件进行数据分析，手术时间、术中出血量、住院时间采用均数±标准差（ x珋±s）表示，组间采用t检验；并发症发生率、患者近期疗效评价采用率表示，采用χ2检验；P＜0．05为差异有统计学意义。结果 TME组患者手术时间（125．52±5．92） min、术中出血量（32．52±4．23） ml、住院时间（12．84±2．98） d均优于传统手术组（158．29±10．22） min、（55．53±3．94） ml、（18．84±3．28） d。 TME组总有效率为85．71％，传统手术组总有效率为63．63％（χ2＝5．632， P＜0．05）。 TME组治疗后第3、5年生存率97．62％、96．43％显著优于传统手术组90．91％、83．33％（χ2＝3．956、4．789， P＜0．05）。 TME组术后生存质量总平均分及各维度得分均高于传统手术组（P＜0．05）。以上各项差异均有统计学意义。结论 TME手术能提高直肠癌患者治疗效果，降低患者复发率，提高患者生存率及生存质量。
목적：탐토전직장계막절제수술（ TME）대직장암환자근원기료효급생존질량적영향。방법장2007년1월지2009년12월수치적150례중저위직장암환자근거환자술식분위TME조84례급전통수술조66례，대량조환자수방5년，대비분석량조환자근원기료효급생존질량。채용SPSS17．0통계학수거연건진행수거분석，수술시간、술중출혈량、주원시간채용균수±표준차（ x류±s）표시，조간채용t검험；병발증발생솔、환자근기료효평개채용솔표시，채용χ2검험；P＜0．05위차이유통계학의의。결과 TME조환자수술시간（125．52±5．92） min、술중출혈량（32．52±4．23） ml、주원시간（12．84±2．98） d균우우전통수술조（158．29±10．22） min、（55．53±3．94） ml、（18．84±3．28） d。 TME조총유효솔위85．71％，전통수술조총유효솔위63．63％（χ2＝5．632， P＜0．05）。 TME조치료후제3、5년생존솔97．62％、96．43％현저우우전통수술조90．91％、83．33％（χ2＝3．956、4．789， P＜0．05）。 TME조술후생존질량총평균분급각유도득분균고우전통수술조（P＜0．05）。이상각항차이균유통계학의의。결론 TME수술능제고직장암환자치료효과，강저환자복발솔，제고환자생존솔급생존질량。
Objective To investigate the outcome of total mesorectal excision ( TME) for patients with rectal cancer as well as their quality of postoperative life . Methods 150 patients with medial-low rectal cancer treated from January 2007 to December 2009 were divided into a TME group ( n=84) and a conventional surgery group (n =66).All of the patients were followed up for 5 years, and comparative analysis was made between the two groups , including short-term and long-term therapeutic efficacy and quality of life.Data analysis was performed by using SPSS 17.0 software, including operative time , blood loss, hospital stay expressed as mean ±standard deviation (mean ±SD) compared by Student's t test, while the incidence of complications and evaluation rate were compared by the Chi -square test.A P value <0.05 was considered statistically significant . Results In the TME group, operative time was (125.52 ±5.92) min, blood loss was (32.52 ±4.23) ml, the length of hospital stay was (12.84 ±2.98) days , which were better than those in the conventional surgery group [(158.29 ±10.22) minutes, (55.53 ±3.94) ml, (18.84 ±3.28) days respectively ].In the TEM group, the total effective rate was 85.71%, while in the conventional surgery group it was 63.63% (χ2 =5.632, P<0.05).The 3-year survival rate was 97.62%, and the 5-year survival rate was 96.43%, which were better than 90.91% and 83.33% respectively in the conventional surgery group (χ2 =3.956, 4.789, P <0.05).In the TME group, the overall average postoperative quality of life and all scores were better than those in the conventional surgery group (P<0.05). All differences were statistically significant . Conclusion TME surgical treatment for rectal cancer could improve clinical outcome , reduce the relapse rate , improve survival and promote the quality of life of patients .