静脉切除对门静脉受累胰腺癌根治术患者近期疗效及远期预后的影响

目的探讨静脉切除对门静脉受累胰腺癌根治术患者近远期疗效。 方法回顾性分析2012年7月至2015年10月85例门静脉受累胰腺癌患者资料，按治疗方式不同分为联合组(n＝45)和常规组(n＝40)。联合组给予胰腺癌根治术联合门静脉切除治疗，常规组采用姑息性旁路手术治疗。数据均用SPSS21.0软件进行统计分析，术中各项指标、生活质量评分等用(均数±标准差)表示，独立t检验；术后并发症发生率、疗效分析、复发率、生存率等采用卡方检验；P<0.05差异有统计学意义。 结果两组手术时间和术后并发症发生率差异无统计学意义(P>0.05)；联合组术中出血量和门静脉阻断时间均明显多于常规组(P<0.05)；联合组治疗有效率(93.3%)显著高于常规组(77.5%)，P<0.05；联合组1年无复发生存率和1年生存率明显优于常规组(P<0.05)，但两组3年无复发生存率和3年生存率差异无统计学意义(P>0.05)；治疗后两组生活质量评分均明显改善，且联合组显著优于常规组(P<0.05)。 结论静脉切除联合胰腺癌根治术用于门静脉受累胰腺癌能有效缓解临床症状，改善生活质量，并发症少，近期疗效显著。

Short-term efficacyvand Long-term prognosis of patients with portal vein-involved pancreatic cancer after radical resection

ObjectiveInvestigate the short-term efficacy and long-term prognosis of patients with portal vein-involved pancreatic cancer after radical resection. MethondFrom July 2012 to October 2015, retrospective analysis of 85 cases of portal vein-involved pancreatic cancer were performed, including 45 cases in combined group and 40 cases in conventional group according to surgical treatments. Briefly, patients in the combined group received radical pancreatic cancer resection combined with portal vein resection, while the conventional group received palliative bypass surgery. The operation condition, short-term therapeutic effect, incidence of complications and survival rate of patients in two groups were compared, and the quality of life of patients were evaluated in both two groups before and after surgery. Statistical analysis were performed by using SPSS 21.0 software. Measurement data, such as quality of life indicators were expressed as( ±s), and were examined by using independent t test. Count data such as therapeutic effects were examined by chi square test. A P value <0.05 was considered as statistically significant difference. ResultsThere were no significant difference between two groups in terms of operative time and incidence of complications (P>0.05). Intraoperative bleeding volume and portal vein occlusion time in the combined group were significantly more than those in the conventional group respectively (P<0.05). The effective rate of the combined group(93.3%) was significantly higher than that in the conventional group(77.5%) (P<0.05). The 1-year recurrence-free survival rate and 1-year survival rate of the combined group were significantly better than those of the conventional group respectively (P<0.05). There was no significant difference between the two groups in terms of 3-year recurrence-free survival rate and 3-year survival rate (P>0.05). After treatment, the quality of life scores of both groups were significantly improved, and the combined group was significantly better than the conventional group (P<0.05). ConclusionPortal vein resection combined with radical pancreatic cancer resection in treatment of pancreatic cancer with portal vein involvement could effectively relieve clinical symptoms and could improve the quality of life, with fewer complications and better short-term effect.