保留幽门胰十二指肠切除术在胰腺癌手术中应用探究.doc

保留幽门胰十二指肠切除术在胰腺癌手术中应用探究【摘要】 目的 探讨保留幽门胰十二指肠切除术在胰腺癌手术中的应用意义及临床价值。方法 回顾性分析50例胰腺癌手术患者，行标准胰十二指肠切除术患者25例为对照组，行保留幽门胰十二指肠切除术25例患者为观察组，对照两组患者手术时间、输血量、最早恢复正常饮食功能时间、总并发症发生率，随访1年后生存率。结果 两组患者手术时间、输血量、最早恢复正常饮食功能时间比较(t=4.33、4.55、4.42，P0.05)。结论 保留幽门胰十二指肠切除术较标准十二指肠切除术手术时间短、输血量少、最早恢复正常饮食功能时间快、总并发症发生率少，临床效果可靠，两组患者一年后生存率具有显著性差异。 【关键词】 保留幽门胰十二指肠切除术；胰腺癌 Pylorus preserving pancreaticoduodenectomy for pancreatic cancer operation in application ZHU Siguo,WANG Ruihai. Shandong Laiwu Central Hospital of Xinwen Mining Group of General Surgery,Shandong 271103,China 【Abstract】 Objective To investigate the pyloruspreserving pancreatoduodenectomy in pancreatic cancer operation significance in the application and clinical value. Methods A retrospective analysis of 50 casesofpancreatic cancer patients with operation, line standard pancreaticoduodenectomy in patients 25 cases as control group, line of pyloruspreserving pancreaticoduodenectomy for the observation group 25 cases, control group two patients with operation time, amount of blood transfusion, the early resumption of normal diet function time, total complication rate, followup after 1 years survival rate. Results In two groups of patients with operation time, amount of blood transfusion, the early resumption of normal diet function time (t=4.33,4.55,4.42, P 0.05). Conclusion Pylorus preserving pancreaticoduodenectomy with standard pancreaticoduodenectomy shorter operation time, less blood transfusion, the earliest to resume a normal diet function time, total complication rate less reliable, clinical effects, two groups of patients after one year survival rate has significant difference. 【Key words】 Pancreatoduodenectomy;Pancreatic cancer 作者单位：271103 山东新汶矿业集团莱芜中心医院 胰腺癌预后极差，对放、化疗均不敏感，目前手术治疗是较好的治疗方法［1］，但手术切除率低且并发症较高，尤其是胃切除后给患者带来的生活质量问题及标准胰十二指肠切除术在创伤程度上、输血量上都较大，给治疗和患者康复带来很多不利影响［2］，以上问题已逐年被专家所重视。近年来研究者［3］提出对胰腺癌患者进行保留幽门胰十二指肠切除术以减少上述情况发生。动物实验研究［4］该术式具有创伤小、简化操作、有利术后营养维持和提高生活质量等优点，它也是近年来胰腺外科的重要研究课题之一［5］。本研究通过对50例患者进行对照研究效果满意特报告如下。 1