胆肠Roux-Y吻合的形态与反流关系的研究  

Shape of Y and its anti-reflux effect after Roux-Y choledochojejunostomy.

作　　者：王庆宝[1] 刘振中[1] 王亚力[1] 金培勇[1] )施宝民[2] 孙庆举[3] 尹化斌[3] 

机构地区：[1]泰山医学院附属医院普外科,泰安271000 [2]同济医科大学附属同济医院外科,430030 [3]泰山医学院附属医院放射科

出　　处：《中国实用外科杂志》1999年第12期729-730,共2页Chinese Journal of Practical Surgery

摘　　要：目的　研究Roux - Y 吻合术后吻合口的形态以及Y 形形态和抗反流的关系。方法　60 例胆肠Roux -Y 吻合的病人分为对照组与改良组。对照组按传统的方法吻合;改良组上行肠袢缩短至25 ～30cm ,近侧肠袢取15～20cm ,同步缝合延长至10 ～12cm 。术后15 ～90 天行2 ～3 次上消化道钡透。结果　(1) 符合Y 形38 例,反流3 例(7-9 % ) ;非Y 形22 例,反流14 例(63-6 % ) 。(2) 改良组符合Y 形者26 例,对照组符合Y 形者12 例,统计学处理两组间差异有极显著意义。结论　(1) 改良法Roux - Y 吻合更符合Y 形态;(2) 符合Y 形者有较好的抗反流效果。Objective To study the morphology of Roux-Y choledochojejunostomy,and to investigate the effects of anti-reflux following the Roux-en-Y anastomosis.Methods 60 patients of Roux-Y choledochojejunostomy were divided into conventional(n=30) and modified(n=30) operation groups.Traditional operation methods were performed in the conventional group.In the modified group,the ascending jejunum loop was reduced to 25～30cm;the proximal jejunum loop was taken 15～20cm;and they were sutured side by side 10～12cm.15 to 90 days after the operation,barium meal examination of digestive tract were performed twice or three times.Results 12 cases of the Roux-Y anastomosises were like“Y” shape in the conventional group,and 26 cases in the modified group.The rate of reflux is 7 9%(3/38) in cases with Y shape after anastomosis and 63 6%(14/22) in cases without standard Y shape.Conclusion (1)The modified technique is useful to make the choledochojejunostomy like “Y” shape.(2)“Y” shape of the choledochojejunostomy is related to the prevention of the reflux into the biliary tree.

关 键 词：胆肠吻合术 ROUX-Y吻合 肠内容反流 

分 类 号：R657.4[医药卫生—外科学] R656[医药卫生—临床医学]