近端胃癌根治术中行胃食管前壁吻合的疗效及对患者胃肠功能恢复的影响  

Effect of Gastroesophageal Anterior Wall Anastomosis in Radical Gastrectomy for Proximal Gastric Cancer and its Effect on the Recovery of Gastrointestinal Function

作　　者：万玉峰 WAN Yu-feng(The First Department of General Surgery,Jiamusi Central Hospital,Jiamusi 154003,Heilongjiang,China)

机构地区：[1]佳木斯市中心医院普外一科,黑龙江佳木斯154003

出　　处：《医学信息》2023年第6期120-123,共4页Journal of Medical Information

摘　　要：目的研究近端胃癌根治术中行胃食管前壁吻合的疗效及对患者胃肠功能恢复的影响。方法选取2021年4月-2022年4月在我院行近端胃癌根治术的90例患者为研究对象,采用随机数字表法分为对照组和观察组,各45例。对照组采用胃食管后壁吻合,观察组采用胃食管前壁吻合,比较两组手术指标(手术时间、术中出血量、淋巴结清扫数目、胃肠道恢复时间)、胃功能指标[胃泌素(GAS)、胃动素(MOT)]、营养指标[血红蛋白(Hb)、血清白蛋白(ALB)、体质量(BMI)]、反流评分及并发症(吻合口出血、狭窄、漏以及肠梗阻)发生率。结果两组手术时间、术中出血量、淋巴结清扫数目、胃肠道恢复时间比较,差异无统计学意义(P>0.05);两组术后4个月GAS、MOT均升高,且观察组高于对照组(P<0.05);两组术后4个月Hb、ALB水平、BMI均低于术前,但观察组高于对照组(P<0.05);观察组术后3、6个月反流评分均低于对照组(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论近端胃癌根治术中行胃食管前壁吻合的疗效确切,可促进胃肠功能恢复,利于营养指标改善,不会增加并发症,可发挥更优的抗反流作用,利于残胃功能的保护,值得临床应用。Objective To study the effect of gastroesophageal anterior wall anastomosis in radical resection of proximal gastric cancer and its effect on the recovery of gastrointestinal function.Methods A total of 90 patients who underwent radical gastrectomy for proximal gastric cancer in our hospital from April 2021 to April 2022 were selected as the research objects.They were divided into control group and observation group by random number table method,with 45 cases in each group.The control group was treated with gastroesophageal posterior wall anastomosis,and the observation group was treated with gastroesophageal anterior wall anastomosis.The operation indexes(operation time,intraoperative blood loss,number of lymph node dissection,gastrointestinal recovery time),gastric function indexes[gastrin(GAS),motilin(MOT)],nutritional indexes[hemoglobin(Hb),serum albumin(ALB),body mass(BMI)],reflux score and incidence of complications(anastomotic bleeding,stenosis,leakage and intestinal obstruction)were compared between the two groups.Results There was no significant difference in operation time,intraoperative blood loss,number of lymph node dissection and gastrointestinal recovery time between the two groups(P>0.05).The GAS and MOT of the two groups increased at 4 months after operation,and those in the observation group were higher than those in the control group(P<0.05).The levels of Hb,ALB and BMI in the two groups at 4 months after operation were lower than those before operation,but those in the observation group were higher than the control group(P<0.05).The reflux scores of the observation group were lower than those of the control group at 3 and 6 months after operation(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion The curative effect of gastroesophageal anterior wall anastomosis in radical resection of proximal gastric cancer is definite,which can promote the recovery of gastrointestinal function,improve the nutritional index,and will not incr

关 键 词：近端胃癌根治术 胃食管前壁吻合 胃肠功能 营养指标 

分 类 号：R735.2[医药卫生—肿瘤]