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1、全胃切除术与近端胃切除术治疗胃上部癌的效果比较［摘要］目的比较全胃切除术与近端胃切除术治疗胃上部癌的效果。方法选取木院2011年2月〜2013年2月收治的68例胃上部癌患者为研究对象，根据不同手术方式将其分为全胃切除术组与近端胃切除术组，各34例，比较两组的手术情况、术后并发症情况及远期生存率等。结果两组的手术时间、术中出血量、排气时间及住院时间比较，差异无统计学意义(P>0.05)。全胃切除术组的术后并发症发生率为20.59%,术后1年存活率为91.18%,近端胃切除术组的术后并发症发生率为29.41%,术后1年存活率为94.12%,两组比较，差
2、异无统计学意义(P>0・05)o结论全胃切除术与近端胃切除术治疗胃上部癌的效果均良好，无明显差异，可根据患者的具体情况选择合适的手术方式。［关键词］全胃切除术；近端胃切除术；胃上部癌［中图分类号］R735.2［文献标识码］A［文章编号］1674-4721(2014)08(a)-0051-03EffectcomparisonoftotalgastrectomyandproximalgastrectomyintreatmentofuppergastriccancerHUANGZheXUFei-pengZHOUCai-jinLINLinZHUWen-ji
3、nWANGWei-weiDepartmentofGastrointestinalSurgery,AffiliatedHospitalofGuangdongMedicalCollege,Zhanjiang524000,China[Abstract]ObjectiveTocomparetheeffectoftotalgastrectomyandproximalgastrectomyinthetreatmentofuppergastriccancer・Methods68patientswithuppergastriccanceradmittedtoour
4、hospitalfromFebruary2011toFebruary2013wereseiectedasthestudysubjectsanddividedintothetotalgastrectomygroupandtheproximalgastrectomygroupaccordingtothesurgicalmethod,andtherewere34patientsineachgroup.Thesurgicalconditions,postoperativecomplicationsandlong-termsurvivalrateofthet
5、wogroupswerecompared.ResuItsTherewasnostatisticaldifferenceofoperationtime,amountofintraoperativebleeding,exausttime,hospitalstayinthetwogroups(P〉0.05)•Inthetotalgastrectomygroup,theincidencerateofpostoperativecomplicationwas20.59%andthepostoperative1-yearsurvivalratewas91.18%
6、whileintheproximalgastrectomygroup,theincidencerateofpostoperativecomplicationwas29.41%andthepostoperative1-yearsurvivalratewas94.12%,andtherewasnostatisticaldifferencebetweenthetwogroups(P>0.05)・ConclusionTotalgastrectomyandproximalgastrectomyshowgoodeffectinthetreatmentofupp
7、ergastriccancer,withoutsignificantdifferences.Theappropriatesurgicalmethodshouldbechosenaccordingtothespecificcircumstancesofpatients.[Keywords]Totalgastrectomy；卩roximalgastrectomy；Uppergastriccancer胃癌因其发生部位不同可分为胃上部癌、中部癌及下部癌［1］,其中胃上部癌指的是发牛在胃上1/3部分的癌症，发生率相对较低，但随着现代生活方式及居住环境的不断改
8、变呈上升趋势［2-3］o由于胃上部癌解剖结构特殊且隐蔽，发现时往往错过最佳治疗时机［4-6］o冃前临床上治疗胃上部癌的原则
