【作者】 李毅成；

【导师】 肖大伟；

【作者基本信息】 汕头大学 ， 胸心外科， 2010， 硕士

【摘要】 目的:食管癌术后生存率以及生活质量受多方面因素影响,如年龄、术前心肺功能、手术切口选择、消化道重建方式、临床分期、术后并发症、术后化疗、饮食营养与精神因素等,本文拟通过探讨临床分期、淋巴结转移情况、术后化疗对食管癌术后存活率及生活质量的影响,为食管癌诊治提供临床依据。方法:2003年至2010年在我院胸外科确诊食管癌并行根治性手术治疗的病例中,有完整资料的共227例,通过电话联系或上门访问,对这227例患者进行跟踪随访,分析影响存活率及生活质量情况的相关因素。采用Kaplan - Meier法计算生存率, Log - Rank检验比较生存差别,生活质量评分采用T检验。结果:不同病理分期对生存率的影响差异具有统计学意义,本组患者Ⅰ期和Ⅱa期、Ⅱb期、Ⅲ期及Ⅳ期1年生存率分别为91.7%、86.8%、65.4%和40% , 3年生存率分别为71.3%、50.2%、38.1%和40%;5年生存率分别为63.3%、40.2%、38.1%和20%。P < 0.01,有显著差异;淋巴结转移阴性患者比阳性患者总体生存期要长, P < 0.01,有显著差异;术后化疗对生活质量的无明显影响,P > 0.05,差异无统计学意义。早期患者的生活质量明显比晚期患者高,P < 0.01,有显著统计学意义(Ⅰ+Ⅱa期与Ⅲ期比较),食管癌淋巴结转移阴性患者与阳性患者生活质量比较,前者生活质量高,P < 0.05,两组患者生存期有统计学意义;术后有否行化疗对患者生活质量影响无统计学意义,P > 0.05。结论:在本研究人群中,临床分期对其存活率及生活质量有显著影响;淋巴结转移对其存活率及生活质量有影响;术后化疗对存活率和生活质量无影响。更多还原

【Abstract】 Objective: The survival rate and quality of life after Esophageal Cancer operation affected by various factors, such as age, preoperative cardiopulmonary function, surgical incision, digestive tract reconstruction, clinical stage, postoperative complications, postoperative chemotherapy, nutrition, mental factors and so on. This paper discusses the clinical stage, lymph node metastases and postoperative chemotherapy on Survival rate and postoperative quality of life after esophageal cancer operation.Methods: A total of 227 cases with esophageal carcinoma underwent radical esophagectomy with complete data who were admitted to 1st Affiliated Hospital of Shantou University Medical College between 2003 and 2010 were selected in this study.Followed up these 227 cases by telephone connection or home visit, analyze the related factors for survival rates and quality of life after esophageal cancer operation. Analyzed the survival rates by Kaplan - Meier method; Analyzed the survival differences by Log - Rank test comparison; Analyzed the the quality of life score by T test.Results: The affect of Different clinical stages on the survival rate is statistical significance, P <0.01.In this group, of StageⅠ&Ⅱa,Ⅱb,ⅢandⅣis 91.7%, 86.8%, 65.4% and 40% , 3 year survival rate is 71.3%, 50.2%, 38.1 and 40%;5 year survival rate 63.3%, 40.2%, 38.1% and 20%. P < 0.01, it is significant. Lymph node metastasis on the survival rate, P < 0.01, it is significant.Postoperative chemotherapy on the survival rate, P > 0.05, the difference was not statistically significant. The affect of Different clinical stages on quality of life is statistical significance, P < 0.01 and it is significant differences (comparison between stageⅠ+Ⅱa andⅢ) . Compared the life quality of Patients with positive lymph node metastasis and patients with negative lymph node metastasis, P < 0.05, both groups was statistically significant. Postoperative chemotherapy on the quality of life had no significant impact, P > 0.05.Conclusions: In this study population, clinical stage on survival rates and quality of life had significant correlation. Lymph node metastasis on survival rates and quality of life had significant correlation.Postoperative chemotherapy on survival rates and quality of life had no significant correlation.更多还原