摘要目的 分析427例胰腺癌患者外科手术治疗的临床效果.方法 选取胰腺癌患者427例作为研究对象.按治疗方式分为三组:根治性切除手术组(包括胰十二指肠切除术组及胰体尾联合脾脏切除组,268例),姑息性手术组(122例),未行手术组(37例).术后评估手术组的并发症发生率及手术死亡率,严密随访3年,比较三组生存率,绘制生存率曲线图;测量三组患者治疗后的生存质量评分,比较各组评分差异,评价手术治疗的临床效果.结果 根治性切除术组术后并发症发生率明显高于姑息性手术组,差异有统计学意义(P<0.05);两组手术组病死率分别为3.35％(9/268)、1.60％(2/122),组间比较差异未见统计学意义(P>0.05).生存率比较,根治性切除术组显著高于其他两组,差异有统计学意义(P<0.01),其1、2、3年生存率分别为52.94％、31.33％、11.74％,明显高于姑息性手术组及未行手术组,差异有统计学意义(P<0.05);而姑息手术组与未手术组比较,差异未见统计学意义(P>0.05).生存质量测评结果表明,手术组分值高于未行手术组,差异有统计学意义(P<0.05),根治性切除术组分值高于姑息性手术组,差异有统计学意义(P<0.05).结论 胰腺癌施行根治切除(包括胰十二指肠切除及胰体尾联合脾脏切除术)能显著提高治疗效果及改善预后,提高远期生存率,同时能明显提高患者的生存质量.对不能根治切除的患者,应争取行姑息性手术,也可提高生存率及改善生存质量.

abstractsObjective To analyze the clinical effects of surgical treatment on 427 cases of pan-creatic cancer .Methods A total of 427 patients with pancreatic cancer were selected .According to treatment patterns , the 427 cases of pancreatic cancer were divided into three groups: radical surgery group ( including pancreatoduodenectomy and pancreatoduodenectomy combined with splenectomy , n=268);palliative operation (n=122) and no surgery group (n=37).The postoperative complication rate and operative mortality were evaluated in the operative group .The follow-up period was 3 years.The sur-vival rates of the three groups were compared , and the survival rate charts were drawn .The quality of life scores of the three groups were measured , and the difference of the scores between the two groups was compared , and the clinical effects of surgical treatment was evaluated .Results The complication rate was significantly higher in radical surgery group than that in palliative group ( P<0.05 ) .The operative mortality in the radical surgery group and palliative group was 3.35％(9/268) and 1.60％(2/122) re-spectively , there was no significant difference between ( P>0.05 ) .The survival rate in the radical re-section group was significantly higher than that in the other two groups , and the differences were signifi-cant (P<0.01).However, the survival rate had no significant difference between palliative group and no surgery group (P>0.05).The survival rates of 1, 2, 3-year in radical surgery group were 52.94％, 31.33％, 11.74％, respectively , which were higher than those in palliative group and no surgery group . There was no significant difference between the palliative group and the no operative group in the 1, 2,&nbsp;3-year survival rates ( P>0.05 ) .The quality of life assessment showed that the score of operation group was higher than that of no operative group , the difference was significant ( P<0.05 ) , and the score of radical resection group was higher than that of palliative operation group , the difference was significant (P<0.05).Conclusions Radical resection of pancreatic cancer (including pancreaticoduodenectomy and pancreatic body tail combined with splenectomy ) can significantly improve the treatment effect and improve prognosis , improve the long-term survival rate , and significantly improve the quality of life of pa-tients.For the patients who can not be excised radical excision , palliative surgery should be strived , in order to improve the survival rate and improve the quality of life .