CAJ | 학술논문

目的：探讨姑息性旁路手术在壶腹周围癌高龄患者根治术中的应用价值。方法将120例壶腹周围癌高龄患者按照随机数字表法，随机均分为观察组和对照组。观察组60例患者，采用姑息性旁路手术治疗。对照组60例患者，采用根治性手术。比较2组患者的术中出血量、手术时间、输血人数、住院天数、减黄效果以及术后情况。结果观察组的术中出血量少于对照组（P＜0．05）；观察组的手术时间、住院天数均短于对照组（P＜0．0001）；减黄效果观察组总有效率为96．67％，对照组为80．00％，差异有统计学意义（μ＝2．1636，P＝0．0305）。观察组的胰瘘、腹腔感染、术后出血、肺炎发生率均少于对照组，差异具有统计学意义（P＜0．05）。观察组与对照组的输血人数，死亡率，伤口感染、胆瘘及胃排空障碍、心脏疾病等并发症发生率差异均无统计学意义（ P＞0．05）。结论姑息性旁路手术在壶腹周围癌高龄患者根治术中的疗效良好，并发症少，值得临床推广。
목적：탐토고식성방로수술재호복주위암고령환자근치술중적응용개치。방법장120례호복주위암고령환자안조수궤수자표법，수궤균분위관찰조화대조조。관찰조60례환자，채용고식성방로수술치료。대조조60례환자，채용근치성수술。비교2조환자적술중출혈량、수술시간、수혈인수、주원천수、감황효과이급술후정황。결과관찰조적술중출혈량소우대조조（P＜0．05）；관찰조적수술시간、주원천수균단우대조조（P＜0．0001）；감황효과관찰조총유효솔위96．67％，대조조위80．00％，차이유통계학의의（μ＝2．1636，P＝0．0305）。관찰조적이루、복강감염、술후출혈、폐염발생솔균소우대조조，차이구유통계학의의（P＜0．05）。관찰조여대조조적수혈인수，사망솔，상구감염、담루급위배공장애、심장질병등병발증발생솔차이균무통계학의의（ P＞0．05）。결론고식성방로수술재호복주위암고령환자근치술중적료효량호，병발증소，치득림상추엄。
Objective To evaluate the value of palliative bypass surgery in radical resection for elderly patients with periampullary cancer .Methods 120 elderly patients with periampullary cancer were randomly divided into the observation group and the control group according to random number table ,each with 60 cases.The observation group received palliative bypass sur-gery.The control group received radical surgery .Blood loss,operative time,blood transfusion number,length of hospital stay,jaun-dice effect and postoperative conditions of the 2 groups were compared .Results Blood loss in the observation group was less than that of the control group(P<0.05);Operative time,hospital stay of the observation group were shorter than that of the control group (P<0.0001);The jaundice effect of the observation group and the control group were 96.67% and 80.00%,there had significant difference (μ=2.1636,P=0.0305).Pancreatic fistula,intra-abdominal infections,postoperative bleeding,pneumonia incidence in the observation group was less than those of the control group ,there was significant difference (P<0.05);there had no significant difference between the 2 groups in complications such as the number of blood transfusions ,mortality,biliary fistula, wound infection,delayed gastric emptying,heart disease (P>0.05).Conclusion Palliative bypass surgery in radical resection for elderly patients with periampullary cancer is effective with fewer complications ,it is worthy of promotion in clinic .