全胃切除术后间置空肠代胃术与Roux-en-Y术消化道重建的疗效观察  

Effects of jejunal interposition and Roux-en-Y surgery after total gastrectomy

作　　者：高少科 李青科[2] 张云昌 牛学瑞 

机构地区：[1]邢矿集团总医院普外科,河北邢台054000 [2]唐山市人民医院普外科,河北唐山063000

出　　处：《局解手术学杂志》2018年第2期111-114,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的观察并比较全胃切除术后间置空肠代胃术与Roux-en-Y术消化道重建的疗效。方法回顾性分析2013年6月至2016年6月我院收治的41例行全胃切除术的胃癌患者的临床资料,根据消化道重建方式不同分为观察组和对照组,观察组采用间置空肠代胃术,对照组采用Roux-en-Y术,对2组患者的疗效进行比较分析。结果 2组患者重建时间、术后住院时间、并发症发生率差异无统计学意义(P>0.05)。术后1年2组并发症发生率、白蛋白、总健康状况评分、疲倦评分、恶心评分观察组优于对照组,差异有统计学意义(P<0.05);2组生存率、血红蛋白、总蛋白、体质量变化差异无统计学意义(P>0.05)。结论全胃切除术后患者行间置空肠代胃术与Roux-en-Y术相比较疗效相当;但间置空肠代胃术可减少远期并发症发生,有助于改善营养水平、提高生存质量。Objective To investigate and compare the effects of jejunal interposition and Roux-en-Y surgery after total gastrectomy. Methods The clinical data of 41 patients with gastric cancer who underwent total gastrectomy in our hospital from June 2013 to June 2016 were retrospectively analyzed. According to the different ways of reconstruction of digestive tract, the patients were divided into observation group and control group. Patients of the observation group were with jejunal interposition surgery ,while patients of the control group were treated with Roux-en-Y surgery, and the effects of the two groups were compared and analyzed. Results There was no significant difference between the two groups in the time of reconstruction,length of hospital stay and the incidence of complications （ P 〉 0.05 ）. One year after surgery, incidence of complications, albumin, total health score ,fatigue score, and disgust score of the observation group were significantly better than those of the control group with statistically significant difference（ P 〈0.05）. There was no significant difference between the two groups in survival rate, hemoglobin, total protein, weight changes （P 〉 0.05 ）. Conclusion For patients with total gastrectomy ,jejunal interposition and Roux-en-Y surgery had similar effect. But in terms of the long-term effect ,jejunal interposition can reduce complications and improve level of nutrition and quality of life.

关 键 词：全胃切除术 间置空肠代胃术 ROUX-EN-Y吻合术 营养状态 生存质量 

分 类 号：R565.1[医药卫生—呼吸系统]