全胃切除术后三种消化道重建方式的对比分析  

Comparctive study on different reconstruction procedures after total gastrectomy

作　　者：王贵和[1] 夏飞[1] 赵铁军[1] 

机构地区：[1]安徽省铜陵市人民医院普外二科,244000

出　　处：《腹部外科》2007年第2期101-102,共2页Journal of Abdominal Surgery

摘　　要：目的探讨不同消化道重建方式对胃癌病人全胃切除术后生活质量、营养状态的影响。方法将我院2004年3月～2005年12月收治的69例行全胃切除术的病人按消化道重建方式的不同分为食管空肠Roux-en-Y吻合术组(R组)、P形空肠食管Roux-en-Y吻合术组(PR组)及P形空肠间置代胃术组(PI组),并对各组术后的生活质量和营养学指标进行对照观察。结果R组反流性食管炎发生率高(20%),VisickⅠ、VisickⅡ级病人比例低于PR组和PI组(P<0.01)。术后1年,PI组进食量、体重、血红蛋白及血浆总蛋白下降程度均显著低于R组和PR组(P<0.01),预后营养指数则高于R组和PR组(P<0.01)。结论P形空肠间置代胃术是全胃切除后一种较为合理的消化道重建方式,能够改善病人术后的生活质量及营养状况。Objective To compare the effects of different reconstruction procedures after total gastrectomy on quality of life and nutritional status. Methods After total gestrectomy, esophagus-jejunum Roux-en-Y,P loop/Roux-en-Y（PR）or p loop interposition（PI）esophagojejunostomy was performad in 69 cases from January 2001 to December 2005. Quality of life and nutritional status were compared between three groups of different reconstruction types. Results The incidence of reflux esophagitis in R group was higher（20%）than in PR and PI groups. But the proportion of the patients with Visick Ⅰ and Visick Ⅱ was lower（P〈0. 01）. One year after operation, decreases of food intake, weight, protein（TP）and hemoglobin（ Hb）were less, but prognostic nutritional index（PNI）was higher in PI group than those in R group and PR group（P〈0.01）. Conclusion P loop interposition is a better reconstruction procedure after total gastrectomy, which can improve postoperative quality of life and nutritional status.

关 键 词：胃肿瘤 胃切除术 生活质量 营养评价 

分 类 号：R738.1[医药卫生—肿瘤]