不同方法治疗 T3、T4期低位直肠癌的疗效对比

目的：探讨T3、T4期低位直肠癌患者进行全直肠系膜切除（ TME）与新辅助放化疗的临床效果观察。方法将96例T3、T4期低位直肠癌患者根据随机数字表法分为研究组、对照组，每组48例。研究组术前进行新辅助放化疗，后予以全直肠系膜切除疗法；对照组先予以全直肠系膜切除，后进行辅助放化疗。比较2组的临床效果及不良反应发生情况。随访12个月，比较2组的生存情况、复发情况、保肛率、根治率、转移率等临床指标。结果研究组的临床有效率为81．2％，显著高于对照组的56．2％，差异有统计学意义（P＜0．05）。研究组的生存情况、复发情况、保肛率、根治率、转移率等临床指标均优于对照组，差异有统计学意义（P＜0．05）。研究组的不良反应发生率12．5％，显著低于对照组的31．1％，差异有统计学意义（ P＜0．05）。结论 T3、T4期低位直肠癌进行术前新辅助放化疗，后予以全直肠系膜手术疗法，可提升患者的生存情况，降低肿瘤的转移及复发，临床效果确切，值得临床推广。

Comparison of Efficacy of Different Treatment for Low Rectal Cancer in T3 and T4 Stage

Objective To explore and analyze the clinical efficacy of TME and neoadjuvant chemotherapy for low rectal cancer in T3 and T4 stage.Methods 96 cases of patients with low rectal cancer were randomly divided into the research group and the control group,each with 48 cases.The research group was given preoperative neoadjuvant chemotherapy and TME thera-py,while the control group was given TME therapy and neoadjuvant chemotherapy.Clinical efficacy and adverse reactions of both groups were compared;after follow-up for 12 months,clinical parameters,including survival condition,recurrence,sphincter pres-ervation rates,cure rates,transfer rate of both groups were compared.Results The clinical effect of the research group (81.2%) was significantly higher than that of the control group (56.2%),there had significant difference (P<0.05);Clinical parameters of survival condition,recurrence,sphincter preservation rate,cure rate,and transfer rate of the research group were significantly better than those of the control group,there had significantly statistical difference (P<0.05);Adverse reaction rate of the re-search group (12.5%) was significantly lower than that of the control group (31.1%),there had statistical difference (P<0.05).Conclusion Preoperative neoadjuvant chemotherapy and TME therapy for low rectal cancer in T3 and T4 stage can effec-tively improve survival condition of patients;reduce metastasis and recurrence,it is worthy of clinical promotion.