改良空肠间置代胃术用于胃癌根治术对患者血常规、营养指数、胃肠激素及CRP水平的影响  

Effect of modified jejunal interposition in radical gastric cancer surgery on patients'blood routine test,nutritional index,and the levels of gastrointestinal hormones and CRP

作　　者：申志成 王守立[1] 赵立志[1] 申力[1] 柏巍松[1] 王志伟[1] 唐继全 唐华[2] SHEN Zhi-cheng;WANG Shou-li;ZHAO Li-zhi;SHEN Li;BAI Wei-song;WANG Zhi-wei;TANG Ji-quan;TANG Hua(Digestive Surgery,Hanzhong Central Hospital,Hanzhong 723000,Shaanxi,CHINA;Endoscopy Center,Hanzhong Central Hospital,Hanzhong 723000,Shaanxi,CHINA)

机构地区：[1]汉中市中心医院消化外科,陕西汉中723000 [2]汉中市中心医院内镜中心,陕西汉中723000

出　　处：《海南医学》2022年第4期448-451,共4页Hainan Medical Journal

基　　金：陕西省卫健委卫生健康科研基金项目(编号:2018C003)。

摘　　要：目的探究改良空肠间置代胃术用于胃癌根治术对患者血常规、营养指数、胃肠激素及C-反应蛋白(CRP)水平的影响。方法回顾性分析2018年12月至2020年12月在汉中市中心医院行胃癌根治术的95例患者的临床资料,按照手术方法的不同分为研究组(改良空肠间置代胃术)50例和对照组(食管残胃吻合术)45例。所有患者均随访6个月。比较两组患者治疗前、治疗后6个月的血常规[血红蛋白(HB)、白蛋白(ALB)、总蛋白(TP)]、营养指数(PNI)、胃肠激素[胃泌素(GAS)、胃动素(MTL)、胆囊收缩素(CCK)、生长抑素(SS)]及CRP水平。结果两组患者的TP、ALB、HB、PNI、GAS、MTL、CCK、SS的时点、组间及时点与组间的交互效应差异均具有统计学意义(P<0.05);术后6个月,研究组患者的TP、ALB、HB、PNI、GAS、MTL、CCK、SS水平明显高于对照组,差异均具有统计学意义(P<0.05),但两组患者术后6个月的CRP水平比较差异无统计学意义(P>0.05)。结论改良空肠间置代胃术用于胃癌根治术可有效改善患者胃肠激素水平,且对患者预后营养状态的改善具有重要作用。Objective To investigate the effect of modified jejunal interposition in radical gastric cancer surgery on patients'blood routine,nutritional index,gastrointestinal hormone and C-reactive protein(CRP)level.Methods A retrospective analysis was conducted on the clinical data of 95 patients who underwent radical gastric cancer surgery in Hanzhong Central Hospital from December 2018 to December 2020.According to the different surgical methods,they were divided into a study group(received modified jejunum interposition,50 cases)and a control group(received esophagusgastric remnant anastomosis,45 cases).All patients were followed up for 6 months.The blood routine test[hemoglobin(HB),albumin(ALB),total protein(TP)]were compared between the two groups before treatment and 6 months after treatment,as well as nutritional index(PNI),the levels of gastrointestinal hormones[gastrin(GAS),motilin(MTL),cholecystokinin(CCK),somatostatin(SS)]and CRP.Results The differences in TP,ALB,HB,PNI,GAS,MTL,CCK,SS of the two groups at different time point between the two groups and the interaction effects between time points and groups were statistically significant(P<0.05).Six months after surgery,the levels of TP,ALB,HB,PNI,GAS,MTL,CCK,and SS in the study group were significantly higher than those in the control group,and all differences were statistically significant(P<0.05).There was no statistically significant difference in CRP levels between the two groups at 6 months after surgery(P>0.05).Conclusion Modified jejunal interposition in radical gastric cancer surgery can effectively improve the level of gastrointestinal hormones and has an important role in improving the prognosis and nutritional status of patients.

关 键 词：胃癌根治术 改良空肠间置代胃术 食管残胃吻合术 胃肠激素 营养指数 

分 类 号：R735.2[医药卫生—肿瘤]