姑息性手术疗法对晚期胰腺癌患者临床效果和生存质量的影响

目的探讨和分析姑息性手术疗法在晚期胰腺癌患者中的临床应用价值。方法选取2008年4月～2013年3月衢州市衢江区人民医院收治的晚期胰腺癌患者86例，随机将患者分为手术治疗组和药物治疗组，每组各43例。药物治疗组患者采用常规化疗药物进行对症治疗，手术治疗组患者采用姑息性手术进行治疗，并分别对两组患者临床治疗效果、生存情况、生存质量改善效果进行比较和分析。结果手术治疗组患者稳定率（39．53％）和疾病控制率（67．44％）均显著高于药物治疗组（23．26％、41．86％），进展率（32．56％）明显低于药物治疗组（58．14％），差异有统计学意义（χ2=2．65、5．68、5．68，P〈0．05）。手术治疗组患者6、12个月生存率（72．09％、25．58％）均明显高于药物治疗组（53．49％、9．30％），平均生存时间（19．75±6．24）个月]显著长于药物治疗组（11．36±5．18）个月]，差异均有统计学意义（χ2=3．19、3．96，t=6．82，P〈0．05）。手术治疗组患者躯体功能、角色功能、认知功能、情绪功能、社会功能、整体功能评分值均显著高于药物治疗组，差异均有统计学意义（t=10．26、9．72、8．29、6．96、8．41、8．33，P〈0．05）。结论姑息性手术疗法对于提高晚期胰腺癌患者的临床疗效，延长生存周期，改善生存质量均具有极其重要的临床意义，可作为晚期胰腺癌患者理想的临床治疗方式予以应用和推广。

Clinical effect and quality life influence of palliative surgical therapy for patients with advanced pancreatic cancer

Objective To investigate the clinical application value of palliative surgical therapy for clinical efficacy and quality of life in patients with advanced pancreatic cancer. Methods From April 2008 to March 2013, 86 patients with advanced pancreatic cancer were selected in Qujiang People＇s Hospital of Quzhou city. The patients were divided into surgical treatment group and drug therapy group with 43 cases in each group. The patients in drug therapy group were treated with conventional chemotherapy drugs for symptomatic. The patients in surgical treatment group were treated with palliative surgery. The clinical effect, survival situations, improvement of quality of life of the patients in two groups were compared and analyzed. Results The stabilization rate and disease control rate in surgical treatment group （39.53%, 67.44%） were all higher than those in drug therapy group （23.26, 41.86%）, the progress rate in surgical treat- ment group （32.56%） was lower than that in drug therapy group （58.14%）, the differences were statistically significant （χ2 = 2.65, 5.68, 5.68, P 〈 0.05）. The 6, 12 months survival rate of in surgical treatment group （72.09%, 25.58%） were all higher than those in drug therapy group （53.4%, 9.30%）, the survival time in surgical treatment group （19.75±6.24） months] was longer than that in drug therapy group （11.36±5.18） months], the differences were statistically significant （χ2 = 3.19, 3.96, t = 6.82, P 〈 0.05）. The score values of physical functioning, role function, cognitive function, emotion function, social function, entirety function in surgical treatment group were all higher than those in drug therapy group, the differences were statistically significant （t = 10.26, 9.72, 8.29, 6.96, 8.41, 8.33, P 〈 0.05）. Conclusion Palliative surgical therapy has clinical implications for improving clinical efficacy, prolonging the lifetime and improving the quality of life of the patients with advanced pancreatic cancer extremely. It can be as ideal clinical treatment for pa- tients with advanced pancreatic cancer to application and promotion.