不同抗反流消化道重建技术在近端胃切除术后胃癌患者中的应用效果  

Application of different anti-reflux digestive tract reconstruction techniques in patients with gastric cancer after proximal gastrectomy

作　　者：蔡敏[1] 魏少忠[1] 罗怡静 Cai Min;Wei Shaozhong;Luo Yijing(Department of Gastrointestinal Surgery,Hubei Cancer Hospital,Wuhan Hubei Province 430079,China)

机构地区：[1]湖北省肿瘤医院胃肠外科,武汉430079

出　　处：《中华普外科手术学杂志（电子版）》2024年第2期137-140,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：湖北省中医药管理局项目(ZY2023Z005)。

摘　　要：目的对比在近端胃切除术后应用不同抗反流消化道重建技术的临床效果。方法回顾性分析2020年1月至2022年12月行近端胃切除术并于术后接受抗反流消化道重建术的83例胃癌患者临床资料,依据抗反流消化道重建方式分为程氏组(接受食管-胃“程氏Giraffe重建术”,n=36例)与间置空肠组(接受间置空肠吻合术,n=47例)。采用SPSS 25.0软件处理数据,围手术期指标、胃肠道症状评定量表(GSRS)评分和术后6个月营养状况等计量资料以(x±s)表示,组间比较用独立样本t检验;术后远期并发症等计数资料用χ^(2)检验。P<0.05为差异有统计学意义。结果程氏组患者术后住院时间短于间置空肠组,差异有统计学意义(P<0.05);术后6个月,程氏组患者血红蛋白、白蛋白及体重增加量均大于间置空肠组,差异均有统计学意义(P<0.05);两组患者远期并发症总发生率对比,差异无统计学意义(P>0.05);与术前相比,术后6个月两组患者GSRS评分均下降,且程氏组患者显著低于间置空肠组,差异有统计学意义(P<0.05)。结论与间置空肠吻合术相比,在近端胃切除术后采用食管-胃“程氏Giraffe重建术”可明显缩短胃癌患者术后住院时间,改善其营养状况并减轻胃肠道症状。Objective To compare the clinical effects of different anti-reflux digestive tract reconstruction techniques after proximal gastrectomy.Methods Clinical data of 83 patients with gastric cancer who underwent proximal gastrectomy and underwent postoperative anti-reflux digestive reconstruction from January 2020 to December 2022 were retrospectively analyzed.According to the methods of anti-reflux digestive reconstruction,they were divided into Cheng group(receiving esophagogastric"Cheng Giraffe reconstruction",n=36 cases)and interposition jejunal group(receiving interposition jejunostomy,n=47 cases).SPSS 25.0 software was used to process the data.Perioperative indicators,gastrointestinal symptom Rating Scale(GSRS)score and nutritional status 6 months after surgery were expressed as(x±s).Independent sample t test was used for comparison between groups.The long term complications were measured byχ^(2) test.P<0.05 was considered statistically significant.Results The length of hospital stay in Cheng's group was shorter than that in interposition jejunum group,and the difference was statistically significant(P<0.05).Six months after surgery,the increase of hemoglobin,albumin and body weight in Cheng's group was higher than that in interposition jejunum group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of long-term complications between the two groups(P>0.05).Compared with pre-operation,GSRS scores in both groups decreased 6 months after surgery,and Cheng's group was significantly lower than interposition jejunum group,with statistical significance(P<0.05).Conclusion Compared with interposition jejunostomy,the use of esophagogastric Giraffe reconstruction after proximal gastrectomy can significantly shorten postoperative hospital stay,improve nutritional status and alleviate gastrointestinal symptoms in patients with gastric cancer.

关 键 词：胃肿瘤 胃切除术 食管-胃“程氏Giraffe重建术” 间置空肠吻合术 手术后并发症 

分 类 号：R735.2[医药卫生—肿瘤]