改良Braun吻合在全胃切除手术中的应用  

Applications of modified braun anastomosis in total gastrectomy surgery

作　　者：周逢强[1] 齐艳美[1] 李乐平 郭辉光[1] 徐宏[1] 

机构地区：[1]山东省滨州市人民医院普外科,256610 [2]山东省省立医院胃肠外科

出　　处：《中国实用医刊》2012年第12期42-43,共2页Chinese Journal of Practical Medicine

摘　　要：目的探讨改良Braun吻合在全胃切除术后消化道重建术中的应用。方法60例患者均采用全身麻醉，均经腹入路。全胃切除后，距屈氏韧带50cm以远处行食管一空肠端侧吻合，在距离吻合口40cm做1个Braun’s侧侧吻合，在侧侧吻合口上10cm输入攀处用7号丝线缝扎肠管，结扎线松紧要适度，可容一血管钳头即可。结果60例患者术后均进行了随访，随访时间6个月-3年。3例死于术后复发和转移；57例存活，未出现饱胀、排空障碍、反流性食管炎和倾倒综合征等并发症。术后经钡餐检查，口服钡剂经过30、60、120min后分别有40％、60％、90％由代胃肠袢排出。Visick分级指数为Ⅰ级26例，Ⅱ级34例。结论全胃切除术行改良Braun吻合，其食物储存量和排空时间较为满意。保证了重建消化道神经一肌肉功能的连续性，减少了并发症，提高了患者的生存质量，是一种比较合理的术式。Objective To investigate the modified Braun anastomosis in reconstruction after total gastreetomy surgery of the digestive tract. Methods Sixty routine total gastreetomy patients underwent jejunostomy loop behalf of the stomach modified Braun-style mateh. Surgery will do a loop-type jejunum Braun＇ s side to side anastomosis, side to side anastomosis in the 10 cm, with 7 silk suture input climbing round. Results Sixty patients had postoperative follow-up for 6 months to 3 years, 3 patients died of re- currence and metastasis. Fifty-seven cases of survival, did not appear fullness, emptying, reflux esoph- agitis and dumping syndrome and other complications; Postoperative barium meal examination, 30, 60, 120 rain after oral administration of barium, respectively, after 40% , 60% , 90% of the discharge by the generation of gastrointestinal loop. Visick grading index： 26 cases of grade Ⅰ , 34 cases of grade Ⅱ. Conclusions Total gastrectomy with modified Braun anastomosis, has good food storage capacity and emptying time. It can reconstruct of the digestive tract to ensure the continuity of nerve muscle function,reduce complications and improve quality of life of patients, is a reasonable surgery.

关 键 词：全胃切除术 Braun吻合 消化道重建术 

分 类 号：R735.2[医药卫生—肿瘤]