幽门成形在近端胃大部分切除术后的临床意义  

The clinical significance of pyloroplasty in the proximal gastrectomy

作　　者：陈振海[1] 刘光艺[1] 曾小葵 李洋[1] 

机构地区：[1]重庆医科大学,400016

出　　处：《重庆医学》2015年第6期790-792,共3页Chongqing medicine

摘　　要：目的探讨幽门成形在贲门胃底部占位性病变行近端胃大部分切除术后的临床效果。方法对2010~2013年重庆医科大学附属第二医院胃肠外科收治的贲门胃底病变患者100例进行前瞻性随机对照试验研究,按照排除标准排除6例,其余94例患者分组,对照组（B组）40例单纯行近端胃大部分切除,试验组（A组）54例患者附加幽门成形,两组均无失访病例。观察比较两组术后住院期间临床观察指标、远期并发症及术后3个月时复查胃镜提示幽门狭窄及反流性食管炎情况。结果两组患者住院期间胃瘫发生率差异无统计学意义（P〉0.05）,其余住院期间各观察指标及远期并发症发生率差异有统计学意义（P〈0.05）。结论近端胃大部分切除附加幽门成形可减少胃潴留及反流性食管炎的发生,减少住院时间,有利于患者术后恢复,适合临床推广应用。Objective To explore the clinical effects of pyloroplasty on proximal gastrectomy in patients with lesions in cardia of the bottom of stomach.Methods One hundred cases of the proximal gastric diseases who were enrolled in the second affiliated hospital of Chongqing medical university from the January 2010 to December 2013 were selected in this prospective randomized controlled experimental study.Among them,6cases were excluded,and the other 94 cases were divided into two groups：the experimental group（A）,in which 54 patients were underwent additional pyloroplasty surgery;the control group（B）,in which 40 patients were underwent with no strings attached pyloroplasty.All patients were followed up.Then,the clinical indicators during hospitalization,term complications and repeated endoscopy prompted pyloric stenosis and reflux esophagitis situation three months after discharged from hospital were observed.Results There was no significant difference in the incidence rate of gastroplegia（P〉0.05）;there were significant differences in other clinical indicators during the postoperative hospitalization and the incidence rate of complications（P〈0.05）.Conclusion Proximal gastrectomy additional pyloroplasty could reduce gastric retention,decrease the incidence of reflux esophagitis,shorten the hospital period and could be helpful for recovery,thus it is recommended to be further promoted.

关 键 词：幽门成形术 近端胃大部分切除术 胃肌轻瘫 幽门狭窄 反流性食管炎 

分 类 号：R656.61[医药卫生—外科学]