胃空肠Roux-en—Y吻合术对远端胃大部切除消化道重建患者胃肠道功能及体质指数的影响  

Effect of gastrojejunostomy Roux-en-Y anastomosis on gastrointestinal function and body mass index in patients with distal gastrectomy and gastrointestinal reconstruction

作　　者：袁宏森[1] 

机构地区：[1]河南省济源市肿瘤医院,454650

出　　处：《中国实用医刊》2018年第16期47-50,共4页Chinese Journal of Practical Medicine

摘　　要：目的 探讨胃空肠Roux-en-Y吻合术对远端胃大部切除消化道重建患者胃肠道功能及体质指数（BMI）变化的影响.方法 选取2013年3月至2016年6月医院62例行远端胃大部切除术患者,依据随机数字表法分为对照组与研究组,每组31例.对照组采用Billroth-I吻合术,研究组采用胃空肠Roux-en-Y吻合术.统计对比两组胃肠道功能恢复情况、并发症发生率、手术前后BMI及血清胃肠激素[生长抑素（SS）、胆囊收缩素（CCK）、胃动素（MTL）、胃泌素（GAS）]水平变化情况.结果 ①胃肠道功能：研究组肠鸣音出现时间、开始进食时间、肛门排气时间、肛门排便时间均少于对照组,差异有统计学意义（P〈0.05）.②BMI：术前两组BMI比较差异未见统计学意义（P〉0.05）,术后1、3个月,研究组BMI高于对照组,差异有统计学意义（P〈0.05）.③血清胃肠激素：术前两组SS、CCK、MTL、GAS水平比较,差异未见统计学意义（P〉0.05）;术后1个月研究组SS、GAS水平高于对照组,CCK水平低于对照组,差异有统计学意义（P〈0.05）.④并发症：研究组倾倒综合征、胃排空障碍、胃潴留发生率[6.45％（2/31）、3.23％（1/31）、19.35％（6/31）]与对照组[9.68％（3/31）、6.45％（2/31）、22.58％（7/31）]比较,差异未见统计学意义（P〉0.05）,研究组残胃炎发生率[12.90％（4/31）]、反流性食管炎发生率[6.45％（2/31）]低于对照组[38.71％（12/31）、29.03％（9/31）],差异有统计学意义（P〈0.05）.结论 胃空肠Roux-en-Y吻合术有助于远端胃大部切除患者胃肠道功能与体质指数及早恢复,对胃肠激素影响较小,可降低反流性食管炎与残胃炎发生率,值得临床推广.Objective To investigate the effect of gastrojejunostomy Roux-en-Y anastomosis on gastrointestinal function and body mass index in patients with distal gastrectomy and gastrointestinal reconstruction. Methods From March 2013 to June 2016, 62 patients with distal gastrectomy were ran- domly divided into the control group （ n = 31 ） and the study group （ n = 31 ） according to the random number table method. The control group was treated with Billroth-I anastomosis, and the study group was treated with Roux-en-Y. The recovery of gastrointestinal function, complication rate, BMI and gastrointestinal hormone in serum [ somatostatin （SS）, cholecystokinin （CCK）, motilin （MTL） and gastrin （GAS） level change ] before and after surgery in the two groups were made statistical comparison. Results ①The function of gastrointestinal tract： the bowel sound time, eating time, anal exhaust time and defecation time in the study group were less than that in the control group, and the difference was statistically significant （ P 〈 0.05 ）. ②Body mass index （BMI） ： There was no significant difference in BMI between the two groups before operation （P 〉 0.05 ）. The BMI of the study group was higher than that of the control group at 1 month and 3 months after operation （ P 〈 0.05 ）. ③Serum gastrointestinal hormones： there was no significant difference in the levels of SS, CCK, MTL and GAS between the two groups before operation （P 〉 0.05 ）. The level of SS and GAS in the study group were higher than that in the control group at 1 month after operation, and the level of CCK was lower than that in the control group （ P 〈 0.05 ）.④Complications ： the incidence rate of dumping syndrome, gastric emptying and gastric retention were 6.45% （2/31）, 3.23% （1/31）, 19. 35% （6/31） in study group and were 9.68% （3/31）, 6.45% （2/31）, 22.58% （7/31） in control group, there were no statistically significant differences （P 〉 0. 05 ）. The incidence of infla

关 键 词：胃空肠Roux—en-Y吻合术 胃癌 消化道重建 胃肠道功能 体质指数 

分 类 号：R735.2[医药卫生—肿瘤]