非离断式Roux-en-Y吻合用于远端胃癌根治术后消化道重建的效果  

Effect of Uncut Roux-en-Y Reconstruction after Distal Gastrectomy for Gastric Cancer

作　　者：何盛泉[1] 骆影超 曾德强[1] 李小文[1] HE Sheng-quan LUO Ying-chao ZENG De-qiang et al.(Yuebei People＇s Hospital, Shaoguan 510202, China)

机构地区：[1]广东省粤北人民医院,广东韶关510202

出　　处：《中国医学创新》2017年第8期127-130,共4页Medical Innovation of China

摘　　要：目的:探究非离断式Roux-en-Y吻合对于远端胃癌根治术后消化道重建的临床效果。方法:选择2013年2月-2015年2月在本院行远端胃癌根治术后的251例患者,根据消化道重建方式分为U-RY组(非离断式Roux-en-Y吻合)80例、B-Ⅰ组(BillrothⅠ式)48例、B-Ⅱ组(BillrothⅡ式)72例、RY组(Roux-en-Y吻合)51例,比较四组手术时间、住院时间、术中出血量、营养指标、术后并发症和患者满意率。结果:U-RY组手术时间长于B-Ⅰ组(P<0.05),但与其他两组比较差异均无统计学意义(P>0.05)。四组术中出血量比较,差异无统计学意义(P>0.05)。U-RY组住院时间均显著短于其他三组(P<0.05)。营养指标除U-RY组甘油三酯和体质量高于其他三组(P<0.05),其余指标四组比较差异均无统计学意义(P>0.05)。U-RY组术后并发症发生率显著低于其他三组(P<0.05),其中Roux-en-Y潴留综合征(RSS)、十二指肠残端瘘和倾倒综合征均未出现。U-RY组患者满意率高于其他三组,差异均有统计学意义(P<0.05)。结论:在远端胃癌根治术后行非离断式Roux-en-Y吻合,可有效重建消化道,缩短住院时间,不增加手术时间和出血量,显著改善术后营养状况,降低并发症发生,尤其避免了RSS等并发症,患者满意度高,值得临床推广。Objective： To evaluate the effect of uncut Roux-en-Y reconstruction after distal gastrectomy for gastric cancer.Method： From February 2013 to February 2015, 251 gastric cancer patients in our hospital were divided into U-RY group （ uncut Roux-en-Y ） 80 cases, B-I group （ Billroth I ） 48 cases, B-I] group （ Billroth [[ ） 72 cases and RY group （ Roux-en-Y ）51 cases after distal gastrectomy according to reconstruction method.The operation time, hospitalization time and intraoperative blood loss, nutrition indexs, postoperative complications and patients＇ satisfaction of four groups were compared.Result： Operation time of U-RY group was longer than that of B- I group （ P〈0.05 ）, and the length of time of U-RY group was significantly shorter than those of the other three groups （ P〈0.05 ） .The triglycerides and body quality index of U-RY group were higher than those of the other three groups （ P〈0.05 ）, the rest of the index and intraoperatie blood loss of four groups had no significant differences （ P〉0.05 ） .The complication incidence of U-RY group was significantly lower than those of the other three groups （P〈0.05）, and Roux-en-Y retention syndrome （ RSS ）, duodenal stump fistula and dumping syndrome did not occur.The patients satisfaction rate of U-RY group was higher than those of the other three groups （ P〈0.05 ） .Conclusion： Uncut Roux-en-Y can shorten hospitalization time, improve postoperative nutritional status, reduce complications, it is worth of promoting.

关 键 词：非离断式Roux-en-Y吻合 消化道重建 远端胃癌根治术 

分 类 号：R735.2[医药卫生—肿瘤]