腹腔镜远端胃大部切除毕Ⅱ式联合Braun吻合术的实践体会  

Practice Experience of Laparoscopic Distal Gastrectomy Type Ⅱ Combined with Braun Anastomosis

作　　者：李起来 LI Qiai(Department of Gastrointestinal Surgery,Chenzhou 3RD People's Hospital(Group),Chenzhou 423000,China)

机构地区：[1]郴州市第三人民医院胃肠外科,湖南郴州423000

出　　处：《中国医药指南》2023年第23期37-40,共4页Guide of China Medicine

摘　　要：目的 分析胃癌患者采用腹腔镜远端胃大部分切除毕Ⅱ式联合Braun吻合术的治疗效果与安全性。方法 将自2018年1月至2022年2月进行治疗的胃癌患者165例纳入至此次研究,对照组(n=72)患者所用术式为用腹腔镜远端胃大部切除毕Ⅱ式,观察组(n=93)患者所用术式为腹腔镜远端胃大部分切除毕Ⅱ式联合Braun吻合术,对比两组手术指标、术后康复指标、手术前后肠道屏障功能水平、营养指标水平、并发症情况及生活质量。结果 两组患者术中出血量、手术持续时间、消化道重建时间、进无渣流食时间、进半流食时间、术后肛门排气时间、引流管拔除时间差异无统计学意义(P> 0.05)。与对照组相比,观察组术后住院用时更短(P <0.05)。术前及术后两组患者二胺氧化酶(DAO)、内毒素(ETX)水平差异均无统计学意义(P> 0.05)。术前两组患者白蛋白(ALB)、血红蛋白(Hb)、总蛋白(TP)及体质量指数(BMI)差异无统计学意义(P> 0.05),手术1年后观察组ALB、Hb、TP及BMI均较对照组高(P <0.05)。与对照组相比,观察组术后具有更低的并发症总发生率(P <0.05)。术前两组患者EORTC生命质量测定量表(QLQ-C30)各维度评分与总评分差异无统计学意义(P> 0.05),手术1年后观察组患者QLQ-C30各维度评分与总体健康评分均较对照组患者高(P <0.05)。结论 胃癌患者采用腹腔镜远端胃大部分切除毕Ⅱ式联合Braun吻合术在胃癌治疗中效果明显,对于改善患者预后、提高其生活品质有重要意义。Objective To analyze the efficacy and safety of laparoscopic distal gastrectomy typeⅡcombined with Braun anastomosis in patients with gastric cancer.Methods A total of 165 patients with gastric cancer who received treatment from January 2018 to February 2022 were included in this study.Patients in the control group(n=72)underwent laparoscopic distal subtotal gastrectomy typeⅡ,and patients in the observation group(n=93)underwent laparoscopic distal subtotal gastrectomy typeⅡcombined with Braun anastomosis.Surgical indexes,postoperative rehabilitation indexes,intestinal barrier function before and after surgery,nutritional indexes,complications and quality of life of the two groups were compared.Results There were no significant differences in intraoperative blood loss,operation duration,digestive tract reconstruction time,slag-free fluid feeding time,semi-fluid feeding time,semi-fluid feeding time and drainage tube removal time between the two groups(P>0.05).Postoperative hospitalization time in observation group was shorter than that in control group(P<0.05).There was no statistical significance in the levels of diamine oxidase(DAO)and endotoxin(ETX)between 2 groups before and after surgery(P>0.05).Before surgery,the differences of albumin(ALB),hemoglobin(Hb),total protein(TP)and body mass index(BMI)between 2 groups were not significant(P>0.05).One year after surgery,ALB,Hb,TP and BMI in observation group were higher than those in control group(P<0.05).The total incidence of postoperative complications in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference between the scores of each dimension and the total score of the EORTC Quality of Life Measurement Scale(QLQ-C30)between the two preoperative groups(P>0.05).One year after surgery,the QLQ-C30 scores and overall health scores in observation group were higher than those in control group(P<0.05).Conclusion Laparoscopic typeⅡcombined with Braun anastomosis is effective in the treatment of g

关 键 词：胃癌 腹腔镜远端胃癌根治术毕Ⅱ式手术 Braun吻合术 肠道屏障功能 营养 并发症 

分 类 号：R735.2[医药卫生—肿瘤]