直肠癌根治术后肝转移的影响因素分析(1)
[摘要] 目的 总结各种病理因素和术后肝转移之间的关系，为今后的康复与随访提供实证性参照。 方法 选取笔者所在医院从2002年2月～2012年1月185例直肠癌根治术患者作为临床研究对象，详细回顾患者病历，并采用门诊复查、信件了解情况和电话访问结合的方式进行随访。考察直肠癌根治术后肝转移的影响因素。 结果 185例患者中肝转移20例，无肝转移165例，转移率为10.8%。肝转移与否与Dukes分期与有无淋巴结转移有显著相关，差异有统计学意义(P<0.05)。 结论 Dukes分期和淋巴结转移是直肠癌根治术后肝转移的危险因素，并且可排除年龄、性别、肿瘤大小等因素的无关性。因此对患者围手术期的治疗与护理，术后的随访和康复都有重大意义，可以改善患者预后。
[关键词] 直肠癌；肝转移；影响因素
[中图分类号] R656.9?[文献标识码] B?[文章编号] 2095-0616(2012)22-215-02
Influence factors analysis of liver metastasis after rectal carcinoma resection
LI?Weixing
Department of the Second Surgery，People's Hospital of Yuexi County，Yuexi 246600，China
[Abstract] Objective To provide empirical reference to the future recovery and follow-up by summarized the relationship between all kinds of pathological factors and postoperative liver metastasis. Methods 185 cases of patients with radical resection of rectal carcinoma in the author's hospital from February 2002 to January 2012 were selected as objects and their medical records were analyzed retrospectively，they were followed up by out-patient review，letters or telephone to investigate the influence factors to postoperative liver metastasis of radical?resection of?rectal carcinoma. Results 20 cases of patients with liver metastasis and 165 cases without liver metastasis，metastasis rate was 10.8%.Liver metastasis was closely correlated with dukes stage and lymph node metastasis，the difference was statistically significant(P<0.05). Conclusion Dukes stage and lymph node metastasis is dangerous factors to postoperative liver metastasis of radical?resection of?rectal carcinoma，and it is not correlated with age，sex and tumor size.So the treatment and nursing between peri-operation，follow-up and postoperative recovery have major implications，they could help to improve their prognosis.
[Key words] Rectal carcinoma；Liver metastasis；Influence factors
由于社会环境和人们饮食结构的改变，结直肠癌(colorectal cancer，CRC)的发病率有呈现上升趋势。其发病率与死亡率已经升至恶性肿瘤的第三位，并且以每年4%的速度在增加[1]。患者自然生存时间约在3～17个月，肝转移灶切除后的5年生存率为30%～50%[2]。笔者对从2002年2月～2012年1月185例直肠癌根治术患者进行病历回顾分析，总结各种病理因素和术后肝转移之间的关系，为今后的康复与随访提供实证性参照，现报道如下。
1?资料与方法
1.1?一般资料
选取笔者所在医院2002年2月～2012年1月185例直肠癌根治术患者作为临床研究对象，所有患者病例均完整，均为根治性手术。其中男106例，女79例；年龄25～82岁，平均(66.1±5.9)岁；Dukes分期：A期46例，B期71例，C期68例；所有患者术前均未经过放疗、化疗，术后3个月内无转移复发或者死亡病例。复发转移均经过病理、X线造影、B超和CT证实。
1.2?随访方式
采用门诊复查、信件了解情况和电话访问结合，在手术后第1年中3个月随访1次，以后半年随访1次。本研究的随访率为100%，中位随访时间42个月。
1.3?统计学处理
数据采用SPSS13.0统计软件进行处理，主要采用x2检验进行分析，以P<0.05为差异有统计学意义。, 百拇医药(李卫星)
[关键词] 直肠癌；肝转移；影响因素
[中图分类号] R656.9?[文献标识码] B?[文章编号] 2095-0616(2012)22-215-02
Influence factors analysis of liver metastasis after rectal carcinoma resection
LI?Weixing
Department of the Second Surgery，People's Hospital of Yuexi County，Yuexi 246600，China
[Abstract] Objective To provide empirical reference to the future recovery and follow-up by summarized the relationship between all kinds of pathological factors and postoperative liver metastasis. Methods 185 cases of patients with radical resection of rectal carcinoma in the author's hospital from February 2002 to January 2012 were selected as objects and their medical records were analyzed retrospectively，they were followed up by out-patient review，letters or telephone to investigate the influence factors to postoperative liver metastasis of radical?resection of?rectal carcinoma. Results 20 cases of patients with liver metastasis and 165 cases without liver metastasis，metastasis rate was 10.8%.Liver metastasis was closely correlated with dukes stage and lymph node metastasis，the difference was statistically significant(P<0.05). Conclusion Dukes stage and lymph node metastasis is dangerous factors to postoperative liver metastasis of radical?resection of?rectal carcinoma，and it is not correlated with age，sex and tumor size.So the treatment and nursing between peri-operation，follow-up and postoperative recovery have major implications，they could help to improve their prognosis.
[Key words] Rectal carcinoma；Liver metastasis；Influence factors
由于社会环境和人们饮食结构的改变，结直肠癌(colorectal cancer，CRC)的发病率有呈现上升趋势。其发病率与死亡率已经升至恶性肿瘤的第三位，并且以每年4%的速度在增加[1]。患者自然生存时间约在3～17个月，肝转移灶切除后的5年生存率为30%～50%[2]。笔者对从2002年2月～2012年1月185例直肠癌根治术患者进行病历回顾分析，总结各种病理因素和术后肝转移之间的关系，为今后的康复与随访提供实证性参照，现报道如下。
1?资料与方法
1.1?一般资料
选取笔者所在医院2002年2月～2012年1月185例直肠癌根治术患者作为临床研究对象，所有患者病例均完整，均为根治性手术。其中男106例，女79例；年龄25～82岁，平均(66.1±5.9)岁；Dukes分期：A期46例，B期71例，C期68例；所有患者术前均未经过放疗、化疗，术后3个月内无转移复发或者死亡病例。复发转移均经过病理、X线造影、B超和CT证实。
1.2?随访方式
采用门诊复查、信件了解情况和电话访问结合，在手术后第1年中3个月随访1次，以后半年随访1次。本研究的随访率为100%，中位随访时间42个月。
1.3?统计学处理
数据采用SPSS13.0统计软件进行处理，主要采用x2检验进行分析，以P<0.05为差异有统计学意义。, 百拇医药(李卫星)