作者：陈烁1，梁小霞2，林镇森3，叶映彤4，陈明扬5，苏树琼6

单位：1.中山大学第一临床医学院，广东 广州 510080; 2.中山大学附属第六医院肿瘤内科，广东 广州 510655; 3.中山大学附属第六医院胃肠外科，广东 广州 510655; 4.中山大学医学院，广东 深圳 518107; 5.中山大学中山医学院，广东 广州 528478; 6.广州皇家丽肿瘤医院肿瘤科，广东 广州 510700

Authors: Chen Shuo1, Liang Xiaoxia2, Lin Zhensen3, Ye Yingtong4, Chen Mingyang5, Su Shuqiong6

Unit：1.The First Clinical Medicine College, Sun Yat-sen University, Guangzhou 510080, Guangdong, China; 2.Oncology Department, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, Guangdong, China; 3.Department of Gastrointestinal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, Guangdong, China; 4.School of Medicine, Sun Yat-sen University, Shenzhen 518107, Guangdong, China; 5.Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 528478, Guangdong, China; 6.Oncology Department, Guangzhou Royallee Hospital, Guangzhou 510700, Guangdong, China

摘要：

目的 对比接受化疗和保守治疗的胃腺癌腹膜转移合并恶性肠梗阻患者的预后，以分析化疗的有效性。方法  本研究回顾性筛查2013年1月至2021年12月中山大学附属第六医院收治的所有胃腺癌腹膜转移合并恶性肠梗阻的病例。根据诊断为恶性肠梗阻后是否行化疗，将研究对象分为保守治疗组和化疗组。利用倾向性匹配，按1∶1 进行配对后，对比和分析两组患者的梗阻缓解率、1 个月内死亡率及总生存时间。结果  共匹配71 对患者，配对后化疗组和保守治疗组的基线资料具有可比性。保守治疗组患者的梗阻缓解率为31.0%，1个月内死亡率为16.9%，中位总生存时间为1.87个月。化疗组患者的梗阻缓解率为76.1%，1个月内死亡率为7.0%，中位总生存时间为6.73个月。与保守治疗组相比，化疗组的梗阻缓解率较高，1个月内死亡率较低，中位总生存时间较长，差异均具有统计学意义(P＜0.05)。结论  对于胃腺癌腹膜转移合并恶性肠梗阻的患者，化疗有效，是重要的治疗选择。

关键词：胃腺癌；恶性肠梗阻；化疗 

Abstract：

Objective Compare the prognosis of gastric adenocarcinoma patients with peritoneal metastasis and malignant bowel obstruction who underwent chemotherapy versus conservative treatment, in order to analyze the effectiveness of chemotherapy. Method This retrospective study screened all cases of gastric adenocarcinoma with peritoneal metastasis and malignant bowel obstruction admitted to the Sixth Affiliated Hospital of Sun Yat-sen University from January 2013 to December 2021. Patients were divided into a conservative treatment group and a chemotherapy group based on whether chemotherapy was administered after diagnosis of malignant bowel obstruction. Using propensity score matching, and pairing in a 1∶1 ratio, the obstruction clearance rates, one-month mortality rates, and overall survival time of the two groups were compared and analyzed. Result  After matching 71 pairs of patients, the baseline characteristics of the matched groups were comparable. The obstruction clearance rate of patients in the conservative treatment group was 31.0%, with a one-month mortality rate of 16.9% and a median overall survival time of 1.87 months. The obstruction clearance rate of patients in the chemotherapy group was 76.1%, with a one-month mortality rate of 7.0% and a median overall survival time of 6.73 months. Compared to the conservative treatment group, the chemotherapy group had a higher obstruction clearance rate, a lower one-month mortality rate, and a longer median overall survival time, with all differences being statistically significant (P＜0.05). Conclusion  For gastric adenocarcinoma patients with peritoneal metastasis and malignant bowel obstruction, chemotherapy is an effective treatment option and plays a crucial role in cancer therapy.

Key Words:  Gastric adenocarcinoma; Malignant bowel obstruction; Chemotherapy

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