2015年12月,50例胃癌合并失代偿期肝硬化的患者,.PDFVIP

·940· ·论著· D1和D2淋巴结清扫术治疗胃癌合并 失代偿性肝硬化的效果比较 沈攀刘琳 [摘要] 目的 比较胃癌合并失代偿性肝硬化患者接受胃癌根治术D1及D2淋巴结清扫的 临床效果。方法 胃癌合并失代偿性肝硬化患者50例，均采用胃癌根治术治疗，根据术中淋巴结 的清扫范围分为Dl组(30例)和D2组(20例)，比较Dl及D2淋巴结清扫的疗效。结果Dl组 淋巴结清扫术1年、3年、5年存活率分别为79．3％、58．1％和28．7％，132组分别为81．1％、 57．1％和30．7％，差异无统计学意义(P0．05)。D2组术后大量腹水、肝功能衰竭的发生率为 85％和30％，D1组分别为33．3％和3．3％，两组比较差异有统计学意义(P0．05)。结论胃癌 B级的患者更加安全有效。 合并失代偿性肝硬化患者，D1淋巴结清扫术对Child—Pugh [关键词] 胃肿瘤； 肝硬化； 淋巴结清扫术； Child—Pu【gh分级 Theclinliceffect betweenD1andD2 nodedissectionin cancer comparison lymph gastric patients 喇th livercirrhosisSHEN General Cen— decompensated Pan，肌UUn．(Departmentof Surgery，Dazhou tral Hospita2．Sichuan635000．China) Abstract To clinliceffect betweenD1andD2 Objectiveinvestigate comparison operative methodsin cancerwith livercirrhosis．MethodsTheclinicaldataof50casesof gastric decompensated canerwith livercirrhosisreceivedradical were gastric decompensated gastrectomyanalyzedretrospective。 ofD1andD2 nodedissectionwas The1一．3一and lY．Thetherapeuticefficacy lymph compared．Results survivalratesofwhichthoseofD1were thoseofD2were 5．year 79．3％．58．1％and28．7％．and thedifferencewasnot 81．1％，57．1％and30．7％，and significant(P0．05)．Theincidence statistically of massiveascitesandliverfailurein D2was85％and30％．whichwas postoperative group significantly thanthatofDl thedifferencewas higher group(33．3％，3．3％)，and statisticallysignificant(P0．05)． ConclusionIn cancer with liver nodedissectionwill cirrhosis．D1 gastric patients