胃切除术后消化道重建术术式的比较  

Comprison of surgical reconstruction of digestive tract after gastric resection

作　　者：沈江 戚灶明 祝俊钜 周洪志 

机构地区：[1]诸暨市人民医院普外科,浙江省诸暨311800

出　　处：《中国基层医药》2011年第2期181-183,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的对比观察全胃切除术后P型空肠襻食管空肠Roux-en-Y吻合术（PRY）与非离断式食管空肠改良Roux-en-Y吻合术（URY）对患者营养状态及消化道症状的影响。方法将152例需行全胃切除术的胃癌患者随机分成两组，每组各76例，分别采用PRY和URY术重建消化道，随访12个月比较两组患者的营养状态及消化道症状。结果PRY组手术时间及术后并发症发生率均大于URY组（均P〈0．05）；两组患者12个月后的病死率、体质量变化、血红蛋白、总蛋白、白蛋白均及反流性食管炎发生率差异均有统计学意义（均P〉0．05）；术后3个月6个月两组进食量〈300ml／次者、进食次数〉5次／d及RSS发生率差异有统计学意义（均P〈0．05）。结论URY术式重建消化道可保持肌电传导的连续性，且手术操作较为简便，术后恢复良好，相对PRY术式而言更加合理。Objective To compare total gastrectomy jejunal loop P-type esophagus jejunum Roux-en-Y anastomosis（PRY） and non-type esophageal transection of the jejunum improved Roux-en-Y anastomosis（URY） two different digestion Road reconstruction on the nutritional status of patients and gastrointestinal symptoms. Methods 152 patients with total gastreetomy required of gastric cancer patients immediately divided into two groups ,76 patients in each group, respectively PRY and URY surgical reconstruction of digestive tract,were followed up for 12 months, two groups were compared on nutritional status and gastrointestinal symptoms. Results PRY operation time and postoperative complication rate were more than URY group（ all P 〈 0.05 ） ; two groups 12 months after the mortality and weight changes,hemoglobin ,total protein, albumin, and all reflux esophagitis the incidence rate was no significant difference （ all P 〉 0. 05 ） ; after 3 months and 6 months in both groups food intake 〈 300ml/second person, eating frequency 〉 5 times/d and the difference in the incidence of RSS had statistical significance （ all P 〈 0.05 ）. Conclusion URY surgical reconstruction of digestive tract and maintain the continuity of muscle conduction, and the surgical procedure was simple, a good prognosis and relatively PRY more reasonable in terms of surgical procedures.

关 键 词：胃肿瘤 胃切除术 消化道重建 

分 类 号：R735[医药卫生—肿瘤]