胃癌患者胃切除后消化道重建手术效果研究  

Research on the effect of gastrointestinal reconstruction after gastrectomy in patients with gastric cancer

作　　者：白少华[1] 朱小明 陈干涛[1] BAI Shao-hua;ZHU Xiao-ming;CHEN Gan-tao(Department of General Surgery,the First People′s Hospital of Xiantao City,Hubei Province,Xiantao 433000,China)

机构地区：[1]湖北省仙桃市第一人民医院普外科,湖北仙桃433000

出　　处：《中国当代医药》2018年第18期49-51,共3页China Modern Medicine

摘　　要：目的探讨胃癌患者行全胃切除术后采用不同方式重建消化道的临床效果。方法择取2016年1月~2017年10月在我院入院治疗的100例胃癌患者,并行全胃切除术予以治疗。术后用随机数字表法将其分为观察组和对照组,每组各50例。观察组采取P型空肠袢食管空肠Roux-en-Y吻合术进行消化道重建,对照组采取Moynihan吻合术进行消化道重建,对两种重建手术用时、术后的营养指标及并发症发生率进行比较,同时采取癌症患者生活质量测量表对两组术后半年的生活质量进行比较。结果两组消化道重建手术时间的比较,差异无统计学意义(P>0.05);观察组的血红蛋白、清蛋白、总蛋白等营养指标水平及生活质量评分平均明显高于对照组,差异均有统计学意义(P<0.05);观察组术后并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。结论全胃切除术治疗胃癌采取P型空肠袢食管空肠Roux-en-Y吻合术重建消化道的并发症风险更低,且相比Moynihan吻合术其应用还可有效提升患者的营养水平及生活质量,P型空肠袢食管空肠Roux-en-Y吻合术具有良好的推广价值。Objective To explore the clinical effect of reconstructing digestive tract if different ways after total gastrectomy in patients with gastric cancer.Methods A total of 100 patients with gastric cancer were selected for this study.All patients were hospitalized from January 2016 to October 2017 and treated with total gastrectomy.After surgery,they were equally divided into observation group and control group by a random number table method.In the observation group,P-shape jejunum pan jejunum esophagus Roux-en-Y anastomosis was used for gastrointestinal reconstruction.In the control group,Moynihan anastomosis for reconstruction of the digestive tract was adopted.The nutritional status and complications of the patients after the two reconstructions were observed.The half-year quality of life in these participants after surgery by the relevant scale was comarped.Results There was no significant difference in the time of gastrointestinal reconstruction between the two groups(P>0.05).The levels of nutritional indexes such as hemoglobin,albumin,and total protein in the observation group were significantly higher than those in the control group.The average score of quality of life was higher in the observation group than the control group with statistical significance(P<0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group with a statistical difference(P<0.05).Conclusion For patients with gastric cancer after total gastrectomy,the risk of complications by P-shape jejunum pan jejunum esophagus Roux-en-Y anastomosis for gastrointestinal reconstruction is lower,which can effectively improve the nutritional status and quality of life compared with Moynihan anastomosis,so P-shape jejunum pan jejunum esophagus Roux-en-Y anastomosis has a good promotion value.

关 键 词：胃癌 全胃切除术 消化道重建 生存质量 安全性 

分 类 号：R735.2[医药卫生—肿瘤]