不同手术方式治疗早期胆囊癌患者的临床疗效及远期生存分析

目的探究不同手术方法治疗早期胆囊癌患者的临床疗效及5年生存率的影响。方法选取2011年1月至2014年2月收治的早期胆囊癌患者84例为实验对象,依据随机数字表法,将入选患者分为两组,每组各42例,其中开腹组行胆囊根治术治疗,腔镜组行腹腔镜胆囊切除术治疗。数据采取SPSS22.0统计软件分析。其中,凝血功能指标凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)及血浆D-二聚体水平]以(±s)表示,采用t检验;并发症发生率用χ^2检验;采用Kaplan-Meier对两组患者的5年生存率进行分析;P<0.05差异有统计学意义。结果腔镜组患者的PT、TT、APTT显著低于开腹组,D-二聚体显著高于开腹组(P<0.05);腔镜组患者的总并发症发生率为16.7%,显著低于开腹组的42.9%,差异有统计学意义(P<0.05);两组5年生存率及复发率差异无统计学意义(P>0.05)。结论两种术式治疗早期胆囊癌均有较理想的疗效,腹腔镜胆囊切除术可显著减少并发症。

Effect and long term survival analysis of different surgical methods on patients with early gallbladder carcinoma

ObjectiveTo investigate the efficacy of different surgical methods in the treatment of early gallbladder carcinoma, and to observe the effect of 5-year survival rate. MethodsThe patients with early gallbladder carcinoma (n=84 cases) from January 2011 to February 2014 were selected as the experimental subjects. According to the random digital table method, the selected patients were divided into two groups, each group was 42 cases, among which the open group was treated by radical cholecystectomy and laparoscopic cholecystectomy was performed in the laparoscopic group. The data were analyzed by SPSS 22.0 statistical software. Among them, the indexes of coagulation function (prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and plasma D-dimer levels) were expressed as ( ±s), and compared with t test The total effective rate was compared with χ² test and the effective rate was compared with rank sum test. Kaplan-Meier was used to analyze the 5-year survival rate (DFS) of the two groups. ResultsThe levels of PT, TT and APTT in the laparoscopic group were significantly lower than those in the open group, the level of D-dimer was significantly higher than that in the open group (P<0.05), and the total complication rate in the laparoscopic group was 16.7%, which was significantly lower than that(42.9%) in the open group (P<0.05). ConclusionBoth the two kinds of operation for early gallbladder carcinoma have good effect, and laparoscopic cholecystectomy can significantly reduce complications.