“G”形路径切除标本后改良贯穿式胰肠连续吻合在胰十二指肠切除术中的临床研究  

Clinical study of modified through penetrating-suture pancreaticojejunostomy after“G” path resection in pancreaticoduodenectomy

作　　者：王晓磊 Wang Xiaolei(Department of General Surgery Shengjing Hospital Affiliated to China Medical University Shenyang Liaoning,Province 110000 China)

机构地区：[1]中国医科大学附属盛京医院普外科,沈阳110000

出　　处：《中华普外科手术学杂志（电子版）》2022年第4期378-381,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：辽宁省重点研发指导计划(2017202008);辽宁省科学技术计划项目(20180580478)。

摘　　要：目的探讨“G”形路径切除标本后改良贯穿式胰肠连续吻合在胰十二指肠切除术(PD)中的临床效果。方法回顾性分析2018年11月至2020年8月80例行“G”形手术路径PD患者的临床资料,按照不同胰肠吻合方式分为传统组(n=35)和改良组(n=45),传统组:行贯穿式胰肠连续吻合;改良组:行改良贯穿式胰肠连续吻合。采用SPSS 22.0统计学软件分析数据。围手术期指标及术后生活质量等计量资料以(x±s)表示,组间比较采用独立样本t检验;术后并发症等计数资料采用χ^(2)检验或Fisher精确检验。P<0.05差异有统计学意义。结果两组患者手术时间及术中出血量比较差异均无统计学意义(P>0.05),改良组的胰肠吻合时间明显长于传统组(P<0.05),引流管留置时间及术后住院时间明显短于传统组(P<0.05);两组患者术后生化瘘,腹腔感染、术后出血、胆瘘及胃瘫的发生情况比较差异无统计学意义(P>0.05),且两组患者均未出现C级胰瘘,而改良组B级胰瘘发生率明显低于传统组(2.2%vs.20.0%.P<0.05);两组患者术后3个月的生理功能、生理职能、躯体疼痛、总体健康、社会功能及情感职能评分比较,差异均无统计学意义(P>0.05)。结论“G”形路径切除标本后改良贯穿式胰肠连续吻合应用于PD中安全有效,能够加快患者术后恢复,缩短住院时间,减少术后B级胰瘘的发生,值得临床推广应用。Objective To investigale the clinical effect of modified though pancreaicojejunostomy in pancreaticoduodenectomy(PD)after“G”shape shaped path resection.Methods The clinical data of 80 cases of PD with“G”shaped surgical path from November 2018 to August 2019 were retrospectively analyzed.According to diferent pancreaticojejunostomy methods,the patients were divided into the traditional group.(n=35)and the modified group(n=45),Traditional group:continuous pancreaticointestinal anastomosis through row;Modified group:underwent modified continwous pancreaticointestinal anastomosis.SPSS 22.0 statistical software was used for analysis.Perioperative indexes and postoperative quality of life were expressed as(x±s).Independent t test was performed between groups.χ^(2) test or Fisher's exact test were used for counting postoperative complications.P<0.05 was statistically significant.Results There was no.significant difference in operation time and intraoperative blood loss between the two groups(P>0.05).The.pancreaticoenterostomy time of the modified group was significantly longer than that of the traditional group(P<0.05),and the duration of drainage tube indplacement and postoperative hospital stay were significantly shorter than that of the traditional group(P<0.05).here was no significant difference in the incidence of postoperative biochemical fistula,abdominal infection.postoperative bleeding,biliary fistula and gastroparalysis between the two groups(P>0.05).and there was no grade C pancreatic fistula in the two groups,while the incidence of grade B pancreatic fistula in the moified group was significanly lower than thal in the traditional group(2.2% vs.20.0%,P<0.05);There was no significant difference in the physiological function,physiological function,physical pain,general health,social function and emotional function between two groups al 3 months afler operation(P>0.05).Conclusion The modified through penetrating-suture pancreaticojejunostomy after“G” shaped path resection is safe and effective in P

关 键 词：胰十二指肠切除术 “G”形路径 改良 吻合方式 

分 类 号：R47[医药卫生—护理学]