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1、全胃切除与近端胃切除治疗胃上部癌的临床近期与远期效果比较［摘要］目的探讨不同方式胃切除治疗胃上部癌的临床近期与远期效果。方法选取我院2012年1月〜2013年12月收治的胃上部癌患者共169例，按照手术方式的不同将其分为对照组和观察组，对照组患者接受近端胃切除治疗，观察组接受全胃切除治疗，比较两组患者手术一般情况、术后并发症发生率、术后2年生存率及转移率。结果观察组手术时间短于对照组，术中出血量少于对照组，差异有统计学意义(PV0.05)。观察组术后血红蛋白及血清清蛋白水平明显高于对照组，差异有
2、统计学意义(P<0.05)o观察组术后并发症发生率与术后2年转移率明显低于对照组，生存率明显高于对照组，差异有统计学意义(PC0.05)。结论全胃切除治疗胃上部癌有较好的临床效果，术后并发症发生率低，远期可提高生存率并降低转移率，值得临床推广应用。［关键词］全胃切除近端胃切除胃上部癌［中图分类号］R735.2［文献标识码］A［文章编号］1674-4721(2016)05(b)-0044-03［Abstract］ObjectiveToexploretheshort-termandlong-term
3、effectsbydifferentgastrectomiesontreatinguppergastriccancer.MethodsFromJanuary2012toDecember2013,169patientswithuppergastriccanceradmittedintoourhospitaiwereselected.Accordingtodifferent,surgicalmethods,theyweredividedintocontrolgroupandobservationgr
4、oup.Inthecontrolgroup,patientsweretreatedbyproximalgastrectomy,whileintheobservationgroup,totalgastrectomywasprovided.Thegeneralconditionofsurgery,incidenceofpostoperativecomplications,andsurvivalrateandmetastasisrate2yearsaftersurgerywerecomparedint
5、hetwogroups.ResultsTntheobservationgroup,operationtimewasshorterandintraoperativeamountofbleedingwaslessincomparisonwiththoseinthecontrolgroup,thedifferencewasstatisticallysignificant(P<0.05)・Thelevelsofhemoglobinandserumalbuminaftersurgeryintheobser
6、vationgroupweremuchhigherthanthoseinthecontrolgroup,thedifferenceswerestatisticallysignificant(P<0.05).Tntheobservationgroup,incidenceofpostoperativecomplicationsandmetastasisrate2yearsaftersurgerywereboth1owerthanthoseinthecontrolgroup.Thesurvivalra
7、tewasgreatlyhigherincomparisonwiththatinthecontrolgroup,thedifferenceswerestatisticallysignificant(P<0.05).ConclusionTotalgastrectomyobtainsagoodeffectontreatinguppergastriccanceratadvantagesoflowincidenceofpostoperativecomplications,improvementofsur
8、vivalrateandreductionofmetastasisrateinalongterm,whichisworthyofclinicalpromotionandapplication.[Keywords]Totalgastrectomy；Proximalgastrectomy；Uppergastriccancer胃癌是我国发病率较高的恶性肿瘤之一，发病率仅次于肺癌，男性发病率高于女性,且胃癌死亡率较高［1-2］o胃上部癌是指发生于贲门至胃大弯及胃小弯上1/3连线区域的恶性肿瘤，由于解剖位
