不同手术方式对贲门癌临床疗效的影响——附491例临床病例分析

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1、徐州医学院硕士学位论文——————————————————————————————————————————————一——_TheClinicalEfficacyofvariousSurgicalMannersontheCardiaCancer——ClinicaIAnaIysisof491CasesAbstractobjectiveThispapersummarizedthecasestudiesatA街liatedHospitalofXuzhouMedicalCollegetoinvestigatethetherapeuticeffec

2、tsofdifferentsurgicalapproachesonthegastriccaridiacancer．MethodsThe491casesofcardiacancerpatientsinOurhospitalWascollectedduringaperiodbetweenNovember2002toNovember2012．Accordingtothedividedsurgicalpathincludingtheapproachesoftransabdominal．transthoracicandtransabdomino—

3、thoracicgroup，thecardiasurgicalapproachwasexploredbyretrospectivestudyofthepatients’gendeLage，symptoms，signs，laboratoryexaminations(gastroscopyandpathologicalexamination，CT,endoscopicultrasonography,X-raycontrast)，surgicalapproach，bloodloss，surgeryandhospitalizationtime，

4、histologicaltype，degreeofdifferentiation，lymphnodedissectionamountandmetastasis，positivemarginrate，anastomoticfistula，complicationafteroperation(pulmonaryinfection,cardiovascularcomplications，woundinfection)，andsurvivalrate。Follow-upstudywasconducted．Thestatisticalanalys

5、isoftheobserveddataiSprocessedbySPSS(versionl6．0)，usingANOVAandKindependentsamplestest．ThesurvivalanalysiswasdonebyKaplan．MeiermethodwithLog．ranktestanalysis，atwhichparticularcase，whenP<0．05，theresultismeaningful．ResultsTherewere491casesofpatientswithAdenocarcinomaofthec

6、ardiainAffiliatedHospitalofXuzhouMedicalCollegebetweenNovember2002toNovember2012，including403malepatients，88femalepatients．Andtheaverageageofadvancedgastriccarcinomawas63．3years(rangingbetween33to89years)．Anditmainlyoccurredamongelderlyindividuals．Thediagnosticaccuracyra

7、teofgastroscopyandpathologicalexaminmion，CT，endoscopicultrasonography,andX—raycontrastwas97．2％．91．2％．89．7％．and78．4％respectively．ItwasfoundthattheGastroscopyisthebesttreatmentiudgingondiagoticaccuracy,whosedifferencesarestatisticallysignificance任k0．05)．Theapproachesoftran

8、smoracic，transabdominalandtransabdomino．thoracichastheirownmeritanddeficiency．Andthegroupoftransabdomin