胰十二指肠切除术后胰胃吻合术与胰肠吻合术的营养状况比较  

Comparison of nutritional status between pancreaticojejunostomy and pancreaticogastrostomy following pancreaticoduodenectomy

作　　者：马晋平[1] 陈创奇[1] 蔡世荣[1] 石汉平[1] 何裕隆[1] 詹文华[1] 

机构地区：[1]中山大学附属第一医院胃肠胰腺外科,广州510080

出　　处：《中华胃肠外科杂志》2012年第5期457-459,共3页Chinese Journal of Gastrointestinal Surgery

基　　金：广东省科技计划项目（20108031600223.20118031800271）

摘　　要：目的比较胰十二指肠切除术后胰胃吻合术与胰肠吻合术患者的远期营养状况。方法回顾性分析2006年4月至2010年12月间在中山大学附属第一医院胃肠胰腺外科接受胰十二指肠切除术的37例患者的临床资料，其中胰胃吻合者19例，胰空肠吻合者18例。比较两组患者的体质量指数（BMI）以及白蛋白、前白蛋白和转铁蛋白等营养参数。结果胰胃吻合组和胰空肠吻合组的手术时间、术中失血量、术后胰瘘发生率、围手术期死亡率及术后住院时间的差异均无统计学意义（均P〉0．05）。术后1个月，胰胃吻合组和胰肠吻合组的BMI分别为（17．1±7．0）和（19．0±4．8）kg／m2。白蛋白分别为（30．1±0．5）和（32．1±1．3）g／L，转铁蛋白分别为（1．89±0．57）和（2．01±0．61）g／L，前白蛋白分别为（0．18±0．05）和（0．18±0．09）g／L。较术前均略有下降，但两组间差异并无统计学意义（均P〉0．05）。术后6个月，两组的上述营养参数均恢复到术前或高于术前水平，但两组间差异仍无统计学意义（均P〉0．05）。结论胰十二指肠切除术后胰胃吻合和胰空肠吻合对患者术后营养状况的影响无明显差别。Objective To compare the nutritional status between pancreaticojejuno-stomy （PJ） and pancreaticogastrostomy （PG） following pancreaticoduodenectomy. Methods A retrospective clinical analysis was performed on 37 patients undergoing pancreaticoduodenectomy（PD）for duodenal carcinoma and pancreatic non-epithelial tumor with PG （n=19） and PJ （n=18） in the First Hospital of Sun Yat-sen University from April 2006 to December 2010. All the patients had a needle catheter jejunostomy inserted at the conclusion of laparotomy. Postoperative early enteral nutrition and parenteral nutrition was performed for all the patients. Nutritional status of two groups was compared in body mass index （BMI）, serum nutritional parameters such as albumin, transferrin and prealbumin before surgery and on 1, 3, and 6 months postoperatively. Results There were no significant differences between PG and PJ groups in operative time, blood loss, pancreatic fistula, perioperative death, or postoperative length of hospital stay. One month after surgery, there were no significant differences in BMI [ （17.1±7.0） vs. （19.0±4.8） kg/m2, P〉0.05], albumin [（30.1±0.5） vs. （32.1±1.3） g/L, P〉0.051, transferrin [（1.89±0.57） vs. （2.01±0.61） g/L, P〉0.05] and prealbumin [（0.18±0.05） vs. （0.18±0.09） g/L, P〉0.05]. These parameters were decreased at 1 month after surgery, and gradually recovered to baseline or higher than the preoperative levels at 6 months after surgery. However, the differences were still not statistically significant between two groups. Conclusions The influence of PJ and PG on the postoperative nutritional status are comparable.

关 键 词：胰十二指肠切除术 胰胃吻合 胰空肠吻合 营养状况 

分 类 号：R735[医药卫生—肿瘤]