评价联合血管切除重建的胰腺癌根治术对胰腺癌患者并发症发生率及生存质量的影响。

回顾性分析2015年5月至2018年5月接受胰腺癌根治术的145例胰腺癌患者临床资料，依据术中是否应用血管切除重建分为A组(无血管切除，n＝77)、V组(静脉切除重建，n＝58)、O组(动脉切除重建，n＝10)三组。采用SPSS 24.0软件进行数据处理，手术相关指标、生存质量及生存时间等计量资料以(±s)表示，组间比较t检验，多组间比较通过单因素方差分析；并发症等组间比较通过χ²检验。检验水准α＝0.05，P<0.05为差异具有统计学意义。

O组手术时间、术中出血量、输血率及并发症发生率>V组>A组(P<0.05)；三组术后6个月健康状况调查简表(SF－36)比术前升高(P<0.05)，但三组相比差异无统计学意义(P>0.05)；三组术中均无死亡病例，A组、V组及O组中位生存时间分别为(16.2±1.5)个月、(15.3±1.2)个月、(14.2±1.9)个月，差异无统计学意义(P>0.05)。

胰腺癌根治术术中联合动、静脉切除均存在手术时间长、出血量多、并发症发生率高等不足，但可获得与无血管切除重建相近的生存时间、预后及生存质量；故在符合手术指征下应推荐无血管切除重建。

To evaluate the influence of radical operation for pancreatic cancer combined with vascular resection and reconstruction on the incidence of complications and quality of life in patients with pancreatic cancer.

The clinical data of 145 pancreatic cancer patients with radical operation for pancreatic cancer from May 2015 to May 2018 were retrospectively analyzed. According to the intraoperative vascular resection and reconstruction, all patients were divided into A group (non-vascular resection, n=77), V group (venous resection and reconstruction, n=58) and O group (arterial resection and reconstruction, n=10). SPSS 24.0 software was used for data processing. The surgical indexes, quality of life and survival time were expressed as (±s). The t test was adopted between groups, the one-way analysis of variance was adopted among groups; The χ² test was adopted to compare the complications among groups. α=0.05, P<0.05 were considered statistically significant.

The operation time, intraoperative bleeding volume, blood transfusion volume and the incidence of complications in O group were higher than those in V group and A group (P<0.05); After surgery for 6 months, the scores of short form-36 health status questionnaire (SF-36) in the three groups were higher than those before surgery (P<0.05), but there was no statistical difference among the three groups (P>0.05); There was no dead cases in the three groups during surgery, the median survival time of A group, V and O group were (16.2±1.5) months, (15.3±1.2) months, (14.2±1.9) months, and the difference was not statistically significant (P>0.05).

Radical operation for pancreatic cancer combined with arterial and venous resection has shortcomings such as long operation time, high bleeding volume and high incidence of complications, but it can obtain similar survival time, prognosis and quality of life with non-vascular resection and reconstruction. Therefore, vascular resection and reconstruction can be recommended in accordance with the indications for surgery.