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目的探讨胃肠肿瘤合并肝硬化门脉高压症患者个体化手术方式治疗的临床效果,为患者制定切实有效的手术治疗方案提供参考数据。方法选取2014年5月—2016年5月广州市第十二人民医院及中山大学附属第一医院收治的76例胃肠肿瘤合并肝硬化门静脉高压患者,随机分为对照组和研究组,每组38例,对照组患者采取脾切除贲门周围血管离断术治疗,研究组患者根据其实际病情选取个体化手术术式治疗,并比较两组患者临床总有效率、术后并发症发生率、平均住院费用和平均住院天数。结果研究组临床疗效总有效率86.84%明显高于对照组的63.16%,差异有统计学意义(P<0.05)。研究组患者术后并发症发生率为5.26%(2/38)明显低于对照组的23.68%(9/36),差异有统计学意义(χ~2=5.208,P=0.022)。研究组患者平均医疗费用(29 998.7±9780.9)元以及住院天数(18.2±3.8)d均明显低于对照组(35 120.5±9 018.2)元、(22.7±5.5)d,差异有统计学意义(t=2.373、4.150,P=0.010、0.000)。结论手术前确定胃肠肿瘤类型,积极评估患者门静脉高压和肝功能情况,针对患者实际病情制定对应手术治疗方案有助于提高胃肠肿瘤合并肝硬化门脉高压患者临床效果、减少住院费用和缩短住院时间。
Objective To investigate the clinical effect of individualized surgical treatment for patients with gastrointestinal neoplasms complicated with cirrhosis and portal hypertension and provide reference data for the development of effective and effective surgical treatment plans. Methods From May 2014 to May 2016, 76 patients with gastrointestinal tumor complicated with cirrhosis and portal hypertension who were admitted to the 12th People’s Hospital of Guangzhou and the First Affiliated Hospital of Sun Yat-sen University were randomly divided into control group and study group, each group Thirty-eight patients in the control group were treated with splenectomy and pericardial vascular disconnection. The patients in the study group were selected according to their actual conditions, and the total effective rate, the incidence of postoperative complications, the mean Hospitalization costs and average length of stay. Results The total effective rate of the study group was 86.84% significantly higher than 63.16% of the control group, the difference was statistically significant (P <0.05). The incidence of postoperative complications in the study group was 5.26% (2/38), which was significantly lower than that in the control group (23.68%, 9/36). The difference was statistically significant (χ ~ 2 = 5.208, P = 0.022). The average medical cost (29 998.7 ± 9780.9) yuan and hospitalization days (18.2 ± 3.8) days in the study group were significantly lower than those in the control group (35 120.5 ± 9018.2 yuan) and (22.7 ± 5.5) days, respectively, with significant difference t = 2.373, 4.150, P = 0.010, 0.000). Conclusions To determine the type of gastrointestinal tumor before surgery, to evaluate portal hypertension and liver function in patients positively. To formulate the corresponding surgical treatment plan according to the actual condition of the patients is helpful to improve the clinical effect of patients with gastrointestinal tumor complicated with cirrhosis and portal hypertension, reduce hospitalization costs and shorten Hospitalization time.