腹腔镜下胆管癌手术患者的生存状况分析

目的探讨胆管癌行腹腔镜下手术患者的短期和长期生存状况。 方法回顾性分析2012年1月至2014年1月接受治疗的96例胆管癌患者(分型为Ⅲa、Ⅲb和Ⅳ)的临床资料，按照手术方法分为2组，引流组应用经肝胆道引流治疗，手术组应用腹腔镜下根治术治疗。采用SPSS23.0软件进行统计学分析。两组计量资料比较采用t检验。术后并发症和近期疗效比较用卡方检验(常规资料)和秩和检验(等级资料)。生存分析模型为Kaplan－meier乘积限模型，两组生存率比较为Logrank检验。P<0.05差异有统计学意义。 结果引流组共有10例完全缓解，21例部分缓解，手术组共有17例完全缓解，27例部分缓解，手术组近期疗效总有效率91.7%，显著高于引流组近期疗效总有效率64.6%(P<0.05)。手术组术后并发症发生率6.3%，明显低于引流组术后并发症发生率29.2%(P<0.05)。引流组1年、3年、5年生存率为39.6%、14.6%和10.4%低于手术组1年、3年、5年生存率为60.4%、22.9%和16.7%，差异有统计学意义(P<0.05)。 结论胆管癌行腹腔镜下手术患者近期疗效较经肝胆道引流治疗显著，且术后并发症发生较少，长期生存率较高，适合临床推广应用。

Analysis of survival status of patients with laparoscopic surgery for cholangiocarcinoma

ObjectiveTo explore the short-term and long-term survival status of patients with laparoscopic surgery for cholangiocarcinoma. MethodsA clinical data of 96 patients with cholangiocarcinoma treated in our hospital from January 2012 to January 2014 were divided into two groups according to the different surgical methods. The drainage group was treated with hepatic biliary drainage and the operation group was treated with laparoscopic radical operation. Statistical analysis was performed using SPSS 23.0 software. The t test was used to compare the two groups of measurement data. Postoperative complications and short-term efficacy were compared using chi-square test (conventional data) and rank sum test (grade data). The survival analysis model was the Kaplan-Meier product limit model, and the survival rate of the two groups was compared with the Logrank test, and P<0.05 was considered statistically significant. ResultsThere were 10 cases of complete remissions in the drainage group and 21cases of partial remissions. There were 17 cases of complete remission in the operation group and 27 cases of partial remission. The total effective rate of the short-term effect in the operation group was 91.7%, which was significantly higher than the total effective rate of the drainage group with 64.6% (P<0.05). The postoperative complication rate was 6.3% in the operation group, which was significantly lower than that in the drainage group of 29.2% (P<0.05). The 1-year survival rate in the drainage group was 39.6%, the 3-year survival rate was 14.6%, and the 5-year survival rate was 10.4%. The 1-year survival rate in the surgery group was 60.4%, the 3-year survival rate was 22.9%, and the 5-year survival rate was 16.7%. The postoperative survival rates between the two groups was statistically significant (P<0.05). ConclusionThe short-term curative effect of laparoscopic surgery for cholangiocarcinoma is significantly better than that of transhepatic biliary drainage. The postoperative complications are less and the long-term survival rate is higher, which is suitable for clinical application.