远端胃癌根治术行BillrothⅠ和改良BillrothⅡ消化道重建后生存质量分析  

Analysis of life quality of patients underwent digestive tract reconstruction by using Billroth Ⅰ and modified BillrothⅡin distal gastrectomy

作　　者：张晓峰[1] ZHANG Xiao-feng(Department of Gastrointestinal Surgery,the first affiliated hospital of Wannan Medical College,Wuhu,Anhui,241000,China)

机构地区：[1]皖南医学院弋矶山医院胃肠外科

出　　处：《齐齐哈尔医学院学报》2019年第22期2814-2816,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨胃癌患者行远端胃大部切除术后行BillrothⅠ式和改良BillrothⅡ式消化道重建的可行性及临床疗效。方法选取2015年1月—2018年11月于本院接受过远端胃癌根治手术的90例患者作为研究对象,按手术术式不同分为B-Ⅰ组(30例)和B-Ⅱ组(60例)两组。回顾性分析两组患者的临床病理特征和围手术期结果。结果两组患者间性别、年龄和体重指数(body mass index,BMI)比较,差异无统计学意义(P<0.05)。围术期:B-Ⅰ组患者的肿瘤临床分期早于B-Ⅱ组,肿瘤直径小于B-Ⅱ组,手术时间短于B-Ⅱ组,术后首次排气时间长于B-Ⅱ组,差异具有统计学意义(P<0.05);术后正常进半流食时间无明显差异(P>0.05)。术后早期并发症:所有患者术后早期胃无力、吻合口出血等并发症的发生率不足5%,两组患者间分别比较均无明显差异(P>0.05)。术后远期症状:B-Ⅱ组患者倾倒综合征等表现的发生率高于B-Ⅰ组,消化道反流症状发生率低于B-Ⅰ组,组间比较均存在统计学差异(P<0.05);其他症状:如消瘦、腹胀等症状及残胃吻合口病变方面两组间比较无显著差异(P>0.05)。结论与B-Ⅰ式相比,改良B-Ⅱ式术后胆汁反流及相关并发症的发生率较低,患者生存质量较高。Objective To investigate the feasibility and clinical efficacy of Billroth I and modified Billroth Ⅱ digestive tract reconstruction in patients with gastric cancer after distal gastrectomy.Methods 90 patients those who ever underwent distal gastrectomy in our hospital during January 2015 and November 2018 were enrolled in this study.They were divided into B-Ⅰ group(n=30) and B-Ⅱ group(n=60) according to the surgery method.The clinicopathological features and perioperative outcomes of the two groups were retrospectively analyzed.Results There were no significant differences in gender,age,and body mass index(BMI) between the two groups.Perioperative period:The clinical stage of the tumor in the B-Ⅰ group was earlier than that in the B-Ⅱ group.The tumor diameter was smaller than that in the B-Ⅱ group.The operation time was shorter than that in the B-Ⅱ group.The first exhaust time was longer than the B-Ⅱ group.There was a statistical difference between the two groups(P<0.05).There was no significant difference between the normal and semi-feeding time(P>0.05).Early postoperative complications:The incidence of complications such as early gastric weakness and anastomotic bleeding in all patients was less than 5%.There was no significant difference between the two groups(P>0.05).Long-term postoperative symptoms:The incidence of dumping syndrome in the B-Ⅱ group was higher than that in the B-Ⅰ group,and the incidence of gastrointestinal reflux symptoms was lower than that in the B-Ⅰgroup.There was a statistical difference between the groups(P <0.05);There were no significant differences between the two groups in terms of symptoms such as weight loss,abdominal distension and residual gastric anastomotic lesions(P>0.05).Conclusions The incidence of postoperative bile reflux and related complications of modified B-Ⅱ is lower compared with B-Ⅰ surgical method,and patients obtain higher quality of life.

关 键 词：胃癌 远端胃大部切除术 消化道重建 围术期 并发症 

分 类 号：R735.2[医药卫生—肿瘤]