两种不同吻合术式对近端胃癌根治术患者术后反流及机体营养恢复的影响  

Clinical observation of postoperative reflux and nutritional recovery of patients after radical proximal gastric cancer resection by using two different anastomosis procedures

作　　者：舒同[1] 文红梅 袁浩[1] 贾贵清[2] Shu Tong;Wen Hongmei;Yuan Hao;Jia Guiqing(Department of General Surgery,Bazhong Hospital of Traditional Chinese Medicine,Sichuan 636000,China;Department of Gastrointestinal surgery,Sichuan People’s Hospital,Sichuan 610000,China)

机构地区：[1]巴中市中医院普外科,四川巴中636000 [2]四川省人民医院肠胃外科,成都610000

出　　处：《中华普外科手术学杂志（电子版）》2019年第6期585-588,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：四川省卫生和计划生育委员会支助项目(18PJ495)~~

摘　　要：目的分析两种不同吻合术式对近端胃癌根治术患者术后反流及机体营养恢复的影响。方法回顾性分析2015年1月至2017年10月行近端胃癌根治术的60例胃癌患者资料,按吻合方式不同分为前壁吻合组(n=30)、后壁吻合组(n=30);采用SPSS 19.0软件对数据进行分析,营养指标、Visick及胃镜下反流性食管炎评分用均数±标准差表示,独立t检验;术后并发症采用χ^2检验;等级资料采用Mann-Whitney U检验。P<0.05为差异具有统计学意义。结果前壁吻合组手术时间较后壁吻合组稍长(P<0.05);前壁吻合组术后3个月、6个月的Visick及胃镜下反流性食管炎评分均显著低于后壁吻合组(P<0.05),Hb、Alb、PNI、PGⅠ均显著高于后壁吻合组(P<0.05)。结论较后壁吻合,近端胃癌根治术中行胃食管前壁吻合或可发挥更佳的抗反流机制,更利于残胃功能恢复,从而改善患者营养状态,值得临床推介。Objective To investigate the clinical outcome of two different anastomosis procedures on postoperative reflux and nutritional recovery of patients after radical operation for proximal gastric cancer.Methods Retrospective analysis of clinical data were performed in 60 patients with gastric cancer who underwent proximal radical gastrectomy from January 2015 to October 2017.The patients were divided into anterior wall anastomosis group(n=30)and posterior wall anastomosis group(n=30)according to different anastomotic methods.SPSS 19.0 software was used to analyze the data.Measurement data such as nutritional indicators,scores of Visick and gastroscopic reflux esophagitis were expressed as mean±standard deviation and were examined by independent t test.Count data such as the incidence of postoperative complications were described by(n,%)and were examined by chi square test.Grade data were examined by using mann-whitney U test.A P value of<0.05 was considered as statistically significant.Results The operation time of anterior wall anastomosis group was slightly longer than that of posterior wall anastomosis group(P<0.05).By using anterior wall anastomosis,Visick and gastroscope under reflux esophagitis scores were significantly lower than those in posterior wall anastomosis group on 3 months,6 months after operation respectively(P<0.05),while Hb,Alb,PNI,PGⅠwere significantly higher(P<0.05).Conclusion Compared with posterior wall anastomosis,the application of gastroesophageal anterior wall anastomosis in radical operation for proximal gastric cancer could play a better anti-reflux role,which is more conducive to the recovery of residual stomach function,thus improving the nutritional status of patients.

关 键 词：胃肿瘤 胃切除术 食管胃接合处 疗效比较研究 

分 类 号：R[医药卫生]