全胃切除后食管空肠Roux-Y吻合术治疗贲门癌的效果及对胃肠屏障功能的影响  

Effect of esophagojejunostomy Roux-Y anastomosis after total gastrectomy in the treatment of cardia cancer and its influence on gastrointestinal barrier function

作　　者：加雄 季刚 陈勇 刘佳 JIA Xiong;JI Gang;CHEN Yong;LIU Jia(Yangling Demonstration Zone Hospital,Xianyang 712100;the First Affiliated Hospitial of Air Force Military Medical University,Xi'an 710032;Shaanxi Provincial Cancer Hospital,Xi'an 710061,China)

机构地区：[1]杨凌示范区医院,陕西咸阳712100 [2]空军军医大学第一附属医院,陕西西安710032 [3]陕西省肿瘤医院,陕西西安710061

出　　处：《临床医学研究与实践》2022年第25期72-75,147,共5页Clinical Research and Practice

摘　　要：目的 探究全胃切除后食管空肠Roux-Y吻合术治疗贲门癌的效果及对胃肠屏障功能的影响。方法 选取2019年1月至2021年11月我院接收的60例贲门癌患者作为研究对象,根据治疗方案将其分为对照组(n=30)和观察组(n=30)。对照组给予全胃切除后食管残胃后壁吻合术,观察组给予全胃切除后食管空肠Roux-Y吻合术。比较两组的治疗效果。结果 观察组的肠鸣音恢复时间、肛门首次排气时间、胃管留置时间及手术时间均短于对照组,术中出血量少于对照组,差异具有统计学意义(P<0.05)。治疗后,两组的二胺氧化酶(DAO)、内毒素、闭锁小带蛋白(ZO-1)及紧密连接蛋白Occludin水平低于治疗前,差异具有统计学意义(P<0.05);治疗后,观察组的DAO、内毒素、ZO-1及紧密连接蛋白Occludin水平低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组的白蛋白(ALB)、转铁蛋白(TRF)及血红蛋白(HB)水平高于治疗前,差异具有统计学意义(P<0.05);治疗后,观察组的ALB、TRF及HB水平高于对照组,差异具有统计学意义(P<0.05)。观察组的并发症总发生率为13.33%,显著低于对照组的36.67%,差异具有统计学意义(P<0.05)。治疗后,两组的饮食受限、胃部疼痛、身体外观及焦虑评分低于治疗前,差异具有统计学意义(P<0.05);治疗后,观察组的饮食受限、胃部疼痛、身体外观及焦虑评分低于对照组,差异具有统计学意义(P<0.05)。结论 全胃切除后食管空肠Roux-Y吻合术治疗贲门癌的效果显著,可改善营养状态,促进机体胃肠屏障功能恢复,降低并发症发生率,提高患者的生活质量,值得临床推广应用。Objective To explore the effect of esophagojejunostomy Roux-Y anastomosis after total gastrectomy in the treatment of cardia cancer and its influence on gastrointestinal barrier function.Methods A total of 60 patients with cardia cancer admitted in our hospital from January 2019 to November 2021 were selected as the research objects,and the patients were divided into control group(n=30)and observation group(n=30)according to the treatment plan.The control group was treated with anastomosis of esophagus and posterior wall of remnant stomach after total gastrectomy,and the observation group was treated with esophagojejunostomy Roux-Y anastomosis after total gastrectomy.The therapeutic effects of the two groups were compared.Results The intestinal sound recovery time,the first anal exhaust time,the gastric tube indwelling time and the operation time of the observation group were shorter than those of the control group,the intraoperative blood loss volume was less than that of the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of diamine oxidase(DAO),endotoxin,zonula occludens-1(ZO-1)and tight junction protein Occludin of the two groups were lower than those before treatment,and the differences were statistically significant(P<0.05);after treatment,the levels of DAO,endotoxin,ZO-1 and tight junction protein Occludin of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of albumin(ALB),transferrin(TRF)and hemoglobin(HB)of the two groups were higher than those before treatment,and the differences were statistically significant(P<0.05);after treatment,the levels of ALB,TRF and HB of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).The total incidence of complications of the observation group was 13.33%,which was significantly lower than 36.67%of the control group,and the difference was statistic

关 键 词：全胃切除 食管空肠Roux-Y吻合术 贲门癌 胃肠屏障功能 

分 类 号：R735[医药卫生—肿瘤]