机构地区:[1]四川省德阳市人民医院血管介入科,德阳市618000 [2]四川绵阳四〇四医院普外科,四川省绵阳市621000
出 处:《广西医学》2020年第3期252-257,共6页Guangxi Medical Journal
基 金:四川省科技支撑计划(2009SZ0100)。
摘 要:目的分析进展期胃癌患者全胃切除调节型双通道间置空肠消化道重建术后的生存质量及营养状况。方法将64例进展期胃癌患者随机分为研究组35例和对照组29例。两组均行全胃切除术,研究组术中采用调节型双通道间置空肠消化道重建术,对照组采用Roux-en-Y吻合术重建消化道。术后1个月、6个月、12个月、24个月、36个月,采用欧洲癌症治疗研究组织(EORTC)生命质量核心问卷(QLQ-C30)以及EORTC胃癌患者生活质量问卷(QLQ-STO22)调查患者的生存质量;术前及术后12个月测量或检测患者的体重、血红蛋白、白蛋白水平;记录术后并发症发生及Clavien-Dindo分级情况。结果两组术后的EORTC QLQ-C30量表各领域评分总体呈增加趋势,其中研究组术后的总体健康状况、躯体功能评分均高于对照组(均P<0.05)。两组术后的EORTC QLQ-STO22量表中胃部疼痛、反流、饮食受限、焦虑、体型评分呈下降趋势,其中研究组患者术后的反流、饮食受限评分均低于对照组(均P<0.05)。在术后1年,两组患者体重、血红蛋白、总蛋白均有不同程度的下降,且研究组下降程度小于对照组(均P<0.05)。两组患者各手术并发症发生率、Clavien-Dindo分级差异均无统计学意义(均P>0.05)。结论与传统Roux-en-Y重建术相比,全胃切除术中采用调节型双通道间置空肠消化道重建,在不增加围术期不良事件的情况下,能提高进展期胃癌患者术后的生活质量,并改善营养状况。Objective To analyze the quality of life and nutrition status in patients with advanced gastric carcinoma afteRtotal gastrectomy with accommodated double-tract digestive reconstruction of jejunal interposition(a-DJI).Methods Sixty-fouRpatients with advanced gastric carcinoma were randomized to study group(n=35)oRcontrol group(n=29).Both groups underwent total gastrectomy,besides,the study group received a-DJI and the control group received Roux-en-Ygastric bypass foRdigestive reconstruction during operation.AfteR1 month,6 months,12 months,24 months and 36 months,quality of life was investigated in all patients using the European Organization foRResearch and Treatment of Cancer(EORTC)Quality of Life Questionnaire-Core 30(QLQ-C30)and EORTC Quality of Life Questionnaire-Stomach 22(QLQ-STO22);before operation and 12 months afteRoperation,the weight,hemoglobin and albumin levels of the patients were measured;the incidence and Clavien-Dindo classification of postoperative complications were recorded.Results The postoperative scores foRall domains of EORTC QLQ-C30 tended to increase generally in both groups,and the scores foRpostoperative general health status and physical function were higheRin the study group than in the control group(all P<0.05).The postoperative scores foRthe items,stomach pain,reflux,dietary restriction,anxiety and somatotype,in EORTC QLQ-STO22 yielded a tendency to decline in both groups,and the study group obtained loweRscores foRpostoperative reflux and dietary restriction as compared with the control group(all P<0.05).One yeaRafteRoperation,the weight,hemoglobin and albumin in both groups were decreased to varying degrees,but the study group obtained minoRdegree of decline as compared with the control group(all P<0.05).There were no statistically significant differences in incidence rates oRClavien-Dindo classification of surgery-induced complications between the two groups(all P>0.05).Conclusion In comparison with conventional Roux-en-Y gastric bypass,application of a-DJI to total gastric carc
关 键 词:胃癌 进展期 全胃切除术 调节型双通道间置空肠消化道重建术 Roux-en-Y重建术 生存质量 营养状况
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