两种吻合术进行消化道重建的临床疗效  

Efficacy of two types of anastomosis for the reconstruction digestive tract

作　　者：万里鹏[1] 万鸿[1] 

机构地区：[1]湖北省黄冈市中心医院胃肠外科,438000

出　　处：《检验医学与临床》2014年第14期1938-1939,1942,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨Orr式Roux-en-Y空肠食管吻合术与Moynihan吻合术用于全胃切除术后消化道重建的疗效。方法将黄冈市中心医院2011年11月至2013年3月收治的胃癌全胃切除术患者184例按照1∶1比例分为A、B两组,每组各92例,A组患者采用Orr式Roux-en-Y空肠食管吻合术进行消化道重建,B组患者采用Moynihan吻合术进行消化道重建,并对两组患者手术情况、术后并发症及远期生存情况进行统计学分析。结果 A组患者手术时间[(172.4±12.2)min]明显短于B组[(198.1±14.7)min],差异有统计学意义(P<0.05);术后随访6个月,B组发生反流性食管炎12例,A组4例,B组高于A组,差异有统计学意义(P<0.05);A组体质量较术前降低值[(6.3±2.8)kg]低于B组[(7.9±3.0)kg],清蛋白[(29.7±6.4)g/L]高于B组[(24.5±5.3)g/L],差异均有统计学意义(P<0.05)。结论 Orr式Roux-en-Y空肠食管吻合术操作简便,用于胃癌全切除后的消化道重建,并发症少,营养恢复好,值得临床广泛推广应用。Objective To investigate the efficacy of Orr-type Roux-en-Y jejunal anastomosis and Moynihan an-astomosis for the reconstruction digestive tract after total gastrectomy .Methods From November 2011 to March 2013 ,a total of 184 patients receiving total gastrectomy were randomly divided into group A and group B with 92 ca-ses in each group .Patients in group A were treated by Orr-type Roux-en-Y jejunal anastomosis ,and patients in group B were treated by Moynihan anastomosis .Condition of surgery ,postoperative complications and long-term survival of patients in the two groups were statistically analyzed .Results The operative time in group A was （172 .4 ± 12 .2） min ,which was significantly shorter than the （198 .1 ± 14 .7）min in group B （P〈0 .05） .During the follow-up of 6 months ,reflux esophagitis occurred in 12 patients of group B and 4 patients of group A ,and the difference was signif-icant （P〈0 .05） ,body weight of patients in group A decreased for （6 .3 ± 2 .8）kg ,lower than the （7 .9 ± 3 .0）kg in group B ,and albumin level in group A was （29 .7 ± 6 .4）g/L ,higher than the （24 .5 ± 5 .3）g/L in group B （P〈0 .05） .Conclusion Application of Orr-type Roux-en-Y jejunal anastomosis for the for the reconstruction of digestive tract might be easy for operation ,and with less complications and promotion of nutritional recovery ,which could be worthy of clinical application .

关 键 词：全胃切除 消化道重建 临床疗效 

分 类 号：R735.205[医药卫生—肿瘤]