两种术式预防胃部分切除术后碱性反流性胃炎的效果及预后观察  

Effects and prognosis of two surgical procedures on prevention of alkaline reflux gastritis after partial gastrectomy

作　　者：罗亮[1] 沈攀 黄智 Luo Liang;Shen Pan;Huang Zhi(Department of General Surgery,Dazhou Central Hospital,Dazhou 635000,China)

机构地区：[1]达州市中心医院普外科,635000

出　　处：《中华保健医学杂志》2020年第2期137-139,共3页Chinese Journal of Health Care and Medicine

基　　金：四川省卫生厅科学研究项目(130476)。

摘　　要：目的观察改良Billroth-Ⅱ术预防胃部分切除术后碱性反流性胃炎(ARG)的效果及对预后的影响。方法选取2014年1月~2017年5月在达州市中心医院接受胃部分切除的患者150例,按消化道重建方式分观察组(改良Billroth-Ⅱ术)与对照组(传统Billroth-Ⅱ术),每组75例。比较两组手术情况、进肠内营养、流食时间及胃液引流液量及住院期间并发症发生情况;统计随访期ARG发生率,并分别以术式、是否发生ARG为因子绘制Kaplan-Meier生存曲线分析预后情况。结果两组患者观察组胃肠引流液量和ARG发生率显著低于对照组,差异有统计学意义(P<0.05),其他术中、术后情况差异无统计学意义(P>0.05)。Kaplan-Meier生存分析显示,观察组累积生存函数优于对照组,差异有统计学意义(P<0.05),但ARG与未发生ARG的患者比较累积生存函数比较,差异均无统计学意义(P>0.05)。结论较传统Billroth-Ⅱ术,改良Billroth-Ⅱ术可降低ARG发生率,于预后有利。Objective To observe the effects of traditional Billroth-II and modified Billroth-II on prevention of alkaline reflux gastritis(ARG)after partial gastrectomy and its influence on prognosis.Methods Patients who underwent partial gastrectomy in the hospital from January 2014 to May 2017 were divided into observation group(modified Billroth-II surgery)and control group(traditional Billroth-II surgery)according to digestive tract reconstruction.The operation status,enteral nutrition,fluid feeding time and gastric fluid drainage volume and occurrence of recent(during hospitalization)complications were compared between the two groups.The incidence rate of ARG was counted during follow-up,and Kaplan-Meier survival curve was drawn by taking surgical procedures and absence or presence of ARG as factors to analyze the prognosis.Results The amount of gastrointestinal drainage fluid and the incidence of Arg in the two groups were significantly lower than that in the control group(P<0.05),but there was no significant difference in other intraoperative and postoperative conditions(P>0.05).Kaplan-Meier survival analysis showed that the cumulative survival function in observation group was better than that in control group(P<0.05),but there was no significant difference in cumulative survival function between patients with ARG and patients without ARG(P>0.05).Conclusion Compared with traditional Billroth-II,modified Billroth-II can reduce the incidence rate of ARG,and it is better for prognosis.

关 键 词：胃部分切除术 碱性反流性胃炎 预后 

分 类 号：R656.61[医药卫生—外科学]