129例胰腺癌临床疗效分析

目的：探讨胰腺癌不同治疗方式与临床疗效及预后的关系。方法：对1996年1月～2004年12月间我院收治的129例胰腺癌患者的临床资料进行回顾性研究。按治疗方式分为3组：胰十二指肠切除术组（28例），姑息手术组（50例），未手术组（51例）。结果：129例患者手术切除率为35．90％（28／78）。生存率3组比较差异有显著性意义（P〈0．01），胰十二指肠切除术组显著高于其他两组（P〈0．01），其1、3和5年生存率分别为67．86％、14．29％和3．57％。姑息手术组的生存率与未手术组比较差异无显著性（P〉0．05）。生存质量测评结果表明，手术组分值显著高于未手术组（P〈0．05），胰十二指肠切除术组分值高于姑息手术组（P〈0．05）。结论：胰腺癌施行根治性胰十二指肠切除术，能显著提高胰腺癌的治疗效果及改善预后，提高远期生存率，同时能明显提高患者的生存质量。对不能根治切除的患者，应争取行姑息性手术，亦可改善生存质量。

Clinical evaluation of the operative effect for 129 cases of pancreatic adenocarcinoma

Objective：To investigate the relation between different oprations and the clinical efficacy, prognosis for pancreatic adenocarcinoma. Methods ： One hundred and twenty-nine patients of pancreatic adenocarcinoma were retmspectly studied. Acorrding to treatment patterns, the patients were divided into three groups ： pancreaticoduodenectomy （ group A, n = 28 ） ; palliative operation （group B, n =50） and unoperative treatment （group C, n =51 ）. Results：In 129 patients the resectability of the tumor was 35.90% （28/78） ;The survival curves were significantly difference among the three groups （P 〈 0. 01 ）. It was significantly higher in group A than in group B and group C（P 〈0. 01 ）. However, the survival rate and survival curves had no statistical significance between group B and group C（P 〉0. 05 ）. The survival rates of 1-, 3-, 5-year in group A were 67. 86% ,14. 29% ,3. 57%, respectively, which were higher than those in group B and group C. According to the results of QOL assessment, the scoring of quality of life were significantly higher in the operative groups than in the unoperative group（ P 〈 0.05 ）, but it was significantly higher in group A than in group B （P 〈 0. 05 ）. Conclusion：Radical pancreaticoduodenectomy could significantly enhance operative effect and improve prognosis of patients suffered from pancreatic adenocarcinoma, particularly, it could improve the long-term survival rate and significantly enhance QOL of the operative patients. For unresectable patients, aggressive palliative surgical management could improve their life quality.