李鹏++杨维桢

[摘要] 目的 探討贲门癌根治性全胃切除术与根治性近端胃切除术的比较情况。 方法 回顾性分析2013年3月～2015年9月宝鸡市中心医院收治的86例贲门癌患者临床资料，依据手术方式不同分为根治性全胃切除术组（43例）和根治性近端胃切除术组（43例）。观察并比较两组贲门癌患者一般手术情况、手术治疗前后生活质量评分情况、术后并发症、术后复发率和1年生存率情况。 结果 两组贲门癌患者手术时间、术中出血量、术后排气时间差异无统计学意义（P > 0.05），两组贲门癌患者治疗前和治疗后日常活动能力、日常生活状态、健康感受、社会支持度、生活感受评分差异无统计学意义（P > 0.05），两组贲门癌患者术后并发症发生率、复发率和1年生存率差异无统计学意义（P > 0.05）。根治性近端胃切除术组贲门癌患者术后胃管引流量高于根治性全胃切除术组，治疗后根治性全胃切除术组和根治性近端胃切除术组日常活动能力、日常生活状态、健康感受、社会支持度、生活感受评分均高于治疗前，差异有统计学意义（P < 0.05）。 结论 贲门癌根治性全胃切除术与根治性近端胃切除术均具有较好的临床疗效，治疗后患者生活质量得到了提高，预后较好，值得临床推广应用。

[关键词] 贲门癌；根治性全胃切除术；根治性近端胃切除术

[中图分类号] R735.2 [文献标识码] A [文章编号] 1673-7210（2017）07（b）-0113-04

Comparison analyzing of cardia cancer by radical total gastrectomy and radical proximal gastrectomy

LI Peng YANG Weizhen▲

Department of General Surgery， Center Hospital on Baoji City， Shaanxi Province， Baoji 721008， China

[Abstract] Objective To dicuss comparison of cardia cancer by radical total gastrectomy and radical proximal gastrectomy. Methods from March 2013 to September 2015， in Center Hospital on Baoji City， the clinical data of 86 cardia cancer patients were retrospective analyzed， they were divided into two groups by different operation methods， radical total gastrectomy group （43 cases） and radical proximal gastrectomy group （43 cases）. The general situation of operation， living quality score before and after treatment， postoperative complications， 1 year survival rate of two groups were observed and compared. Results The operation time， intraoperative blood loss， postoperative exhaust time of two groups were compared， the difference was not statistically significant （P > 0.05）. The daily activity ability， daily life state， health feelings， social support， life apperception score of two groups before treatment and after treatment were compared， the difference was not statistically significant （P > 0.05）. The postoperative complications， postoperative recurrence rate and 1 year survival rate of two groups compared， the difference was not statistically significant （P > 0.05）. The postoperative gastric tube flow of radical proximal gastrectomy group were higher than that of radical total gastrectomy group， the daily activity ability， daily life state， health feelings， social support， life apperception score of radical total gastrectomy group and radical proximal gastrectomy group after treatment were higher than those before treatment， the differences were statistically significant （P < 0.05）. Conclusion The radical total gastrectomy and radical proximal gastrectomy of cardia cancer have good clinical effect， they can increase living quality of patients after treatment， the prognosis is good， it is worth to be used.

[Key words] Cardia cancer； Radical total gastrectomy； Radical proximal gastrectomy

胃癌作为消化系统常见的恶性肿瘤，每年全球发生率达到90万例，其中每年死亡的胃癌例数达到70万[1-2]。随着我国医疗服务水平的不断提高和发展，对于胃癌的临床认知度明显增加，胃癌发生率和死亡率也呈现明显降低趋势[3-4]。贲门癌属于临床上比较少见的胃癌类型，其临床症状不是十分明显，很容易被患者忽视，一旦确诊多数处于中晚期[5-6]。目前贲……