全胃切除术后两种不同消化道重建法对胃肠动力影响的比较  

Comparison of the effects of two different reconstruction methods after total gastrectomy on gastrointestinal motilitv

作　　者：秦新裕[1] 雷勇[1] 

机构地区：[1]上海复旦大学附属中山医院普外科,200032

出　　处：《消化外科》2002年第2期87-88,共2页Journal of Digestive Surgery

基　　金：国家自然科学基金资助(No. 30070738)

摘　　要：目的 探讨全胃切除术后两种常用的消化道重建术式对胃肠动力学与体重的影响进行了比较。方法50只雄性Sprague-Dawley鼠随机分成5组:对照组（C组）、剖腹组（L组,仅剖腹）,空肠切断吻合组（JT组,距Traiz韧带10cm处切断空肠,然后再吻合）。空肠间置组（JI组,全胃切除术后间置5cm空肠）。Roux-en-Y组（RY组,全胃切除术后行食管空肠Roux-en-Y重建术）。结果 术后6月RY组体重低于术前[（247.7±13.4）g　vs（29.0±12.0）g,P<0.01],而JI组体重较术前增加[（385.0±21.2）g vs（299.5±8.3）g,P<0.01]。RY组小肠转运速度为（24.8±10.3）cm/30min,而对照组为（54.67±6.7）cm/30min（P<0.01）,RY组小肠转运速度明显慢于对照组。JI组、L组以及JT组小肠转运速度与对照组相比,差别无显著性。结论 全胃切除术后采用空肠间置重建消化道的大鼠,在手术后6月时其胃肠动力和体重的变化均优于Roux-en-Y组。Objective To compare the effects of Roux - en - Y and jejunum interposition after total gastrectomy on intestinal motility. Methods 50 male Sprague - Dawley rats were divided into 5 groups: the control group, the lapa-rotomy group, the jejunal transection group where the jejunum was transected and anastomosed 10 cm distally from the Traiz ligament, the Roux - en - Y group (RY) and the jejunum interposition group (JP) . The animal was given 0. 1 ml Evans blue solution through an orogastric tube. 30 minutes later the rats were executed by C02 inhalation and the intestinal transit was determined as the distance between the site of esophageogastric anastomosis and the most distal site of small intestine colored with blue. Results 6 months after the operation, the body weight in the JP group increased compared to the preoperative level (385.0±21.2 g vs 299.5±8.3 g, P < 0.01). However, the body weight of the RY group decreased compared to preoperation (247.7±13.4 g vs 295.0±12.0 g, P < 0. 01). The small bowel transit time in RY group is slower than that in JP group and control group ( P < 0.01). Conclusions The body weight changes and intestinal motility in JP group are less infulenced than in RY group.

关 键 词：消化道重建法 全胃切除术 空肠间置术 Roux-en-Y食管空肠吻合术 胃肠动力 动物实验 

分 类 号：R735.2[医药卫生—肿瘤]