保留迷走神经的胃幽门部分切除术对早期胃体癌的疗效影响  

Effect influence of pylorus preserving gastrectomy in the treatment of early gastric cancer

作　　者：伍贵祥[1] 

机构地区：[1]陕西省汉中市人民医院普外科,陕西汉中723000

出　　处：《中国现代普通外科进展》2016年第7期523-526,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的：研究保留迷走神经的胃幽门部分切除术（PPG）对早期胃体癌患者的疗效影响。方法：选择2008年6月—2015年6月接受手术治疗的早期胃体癌患者88例进行研究,其中接受PPG治疗者43例,纳入观察组;接受传统胃癌远端切除术（D G）治疗者45例,纳入对照组。随访5年,对比两组术后的胃排空功能及胆囊收缩功能、5年存活率、复发与转移情况以及并发症情况。结果：观察组15~60 m in的胃排空功能以及45~60 m in的胆囊收缩功能均分别显著优于对照组,差异有统计学意义（P〈0.05）。两组术前及术后即刻的A M S、Try-2、A LP、γ-G T、胃液p H及胃泌素水平相比,差异无统计学意义（P〉0.05）。两组术后1个月的上述指标水平均分别较术前显著降低,但观察组仍显著高于对照组,差异有统计学意义（P〈0.05）。两组术后的5年总生存率相比,差异无统计学意义（P〉0.05）。观察组复发与转移的总发生率为9.30%（4/43）,与对照组的20.00%（9/45）相比,差异无统计学意义（P〉0.05）。两组术后并发症相比,差异无统计学意义（P〉0.05）。结论：利用PPG治疗早期胃体癌患者,能够有效改善患者的胃排空及胆囊收缩功能,具有较高的5年生存率,不会增加复发与转移率,安全性较高,值得推荐。Objective：To study effect influence of pylorus preserving gastrectomy in the treatment of early gastric cancer.Methods：From June 2008 to June 2015 accepted surgical treatment of early gastric cancer patients of 88 cases as for research,which accepted the PPG surgical treatment of 43 cases was into observation group,accept DG operation of 45 cases was into the control group, followed up for 5 years, compared two groups of patients after gastric emptying function and the contraction function of gallbladder, 5 year survival rate, recurrence and metastasis and complica- tions. Results： The 15-60 rain gastric emptying function of the observation group was significantly better than the control group（P〈 0.05）, and the function of gallbladder contraction in the 45 ~ 60 rain were significantly higher than those in the control group （P〈 0.05）. There was no significant differ- ence in the AMS, ALP, Try-2, γ -GT, PH and gastrin levels between the two groups before and af- ter operation in the two groups（P〉 0.05）, 1 month after operation, the levels of the above index- es were significantly lower than before operation, but the observation group was significantly higher than that of the control group, the difference was statistically significant（P〈 0.05）. There was no significant difference between the two groups（P〉 0.05） and the long-term outcome after 5 years of operation. The total incidence of recurrence and metastasis in the observation group was 9.30% （4/43）, compared with the control group 20.00% （9/45）, the difference was not statistically signifi- cant（P〉 0.05）. There was no significant difference between the two groups（P〉 0.05）. Conclusion： The use of PPG surgical treatment of early gastric cancer patients, can effectively improve the patients of gastric emptying and gallbladder contraction function, with a high 5 years survival rate, not increase the rate of recurrence and metastasis, high security, worthy of recommendation.

关 键 词：保留迷走神经 胃幽门部分切除手术 早期胃体癌 疗效 

分 类 号：R735.2[医药卫生—肿瘤]