摘要
目的 分析复发性卵巢癌患者合并肠梗阻行姑息性手术治疗的临床应用。方法 回顾分析 1997～ 2 0 0 2年采用姑息性手术治疗 (手术治疗 )的 6 7例复发性卵巢癌合并肠梗阻患者 ,并与同期未行手术治疗 (非手术治疗 )的 75例复发性卵巢癌合并肠梗阻患者进行比较。采用COX回归分析法 ,分析行手术治疗患者选择的参考指标。结果 手术治疗的 6 7例患者中 ,5 8例 ( 86 6 % )完成预期手术操作 ,4 3例症状获得成功缓解 ,缓解率 6 4 2 % ( 4 3/6 7) ,占所有肠梗阻患者的 30 3% ( 4 3/14 2 )。6 7例患者的中位数生存期为 7 8个月 ,4 3例症状获得成功缓解患者的中位数生存期为 12 6个月 ;非手术治疗患者的中位数生存期为 3 7个月。 6 7例患者的围手术期死亡率为 6 0 % ( 4 /6 7) ,并发症发生率为 2 2 4 % ( 15 /6 7)。单纯结肠发生梗阻和复发肿块位于盆腔 ,可作为采用手术治疗患者选择的参考指标。结论 采用姑息性手术治疗复发性卵巢癌合并肠梗阻 ,可使约 1/3的患者获得较好疗效 ;而选择恰当的患者 。
Objective Intestinal obstruction is a frequent sequela of recurrent ovarian cancer and difficult to deal with We analyzed a series of such patients to determine if their outcomes have changed after undergoing palliative surgery Method We retrospectively reviewed 67 patients undergoing surgery for intestinal obstruction due to recurrent ovarian carcinoma and 75 patients receiving non surgical treatmen from 1997 to 2002 Results During the study period,67 operations were performed on 67 patients Among them,surgical procedure was completed in 58 cases Successful palliation was achieved in 64 2% of cases in which surgical correction was possible The median survival of the entire cohort was 7 8 months,and 12 6 months for the surgically successfully relieved patients and 3 7 months for those non surgical patients The rate of major surgical morbidities was 22 4 % The perioperative mortality rate was 6 0% Successful palliation was associated with the absence of two prognostic factors:multiple obstructive sites and palpable abdominal and pelvic masses Conclusion Palliative surgery for bowel obstruction in recurrent ovarian cancer can be worthwhile,and properly selected patients are the key to its success
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2004年第4期260-263,共4页
Chinese Journal of Obstetrics and Gynecology
关键词
复发性卵巢癌
肠梗阻
姑息性手术
临床分析
治疗
Ovarian neoplasms
Neoplasm recurrence, local
Intestinal obstruction
Palliative care
