不同吻合术在行腹腔镜远端胃癌根治术患者中的应用效果  

Application Effect of Different Anastomosis Techniques in Patients Undergoing Laparoscopic Distal Radical Gastrectomy for Gastric Cancer

作　　者：孙启强 陈永安[1] 吴思懿 SUN Qiqiang;CHEN Yong'an;WU Siyi(Department of Surgery,Fuding Hospital,Fuding Fujian 355200,China)

机构地区：[1]福鼎市医院外科,福建福鼎355200

出　　处：《中国卫生标准管理》2024年第10期104-107,共4页China Health Standard Management

摘　　要：目的 探讨不同吻合术在行腹腔镜远端胃癌根治术(laparoscopic distal radical gastrectomy,LDRG)患者中的应用效果。方法 选取2020年3月—2022年3月于福鼎市医院行LDRG的58例患者。采用随机数字表法分为观察组29例与对照组29例。对照组术后接受Roux-en-Y吻合术,观察组患者术后接受非离断Roux-en-Y吻合术。比较2组患者手术指标、术后并发症发生率以及患者生活质量。结果 观察组排气时间短于对照组(P<0.05),2组手术时间、吻合时间、住院时间、术中出血量、淋巴结清扫数目比较,差异无统计学意义(P>0.05)。观察组患者术后6个月ROUX淤滞综合征(ROUX stasis syndrome,RSS)发生率为3.45%,低于对照组的27.59%(P<0.05);2组吻合口出血、胃食管反流、吻合口溃疡、吻合口瘘、腹腔感染发生率比较,差异无统计学意义(P>0.05)。术后2组患者各项健康调查简表(the MOS item short from health survey,SF-36)评分高于术前,且术后观察组各项SF-36量表评分均高于对照组(P<0.05)。结论 对LDRG患者术后采用非离断Rouxen-Y吻合术可降低患者排气时间,降低RSS的发生率,同时不会增加其他并发症发生,并改善患者生活质量。Objective To explore the application effect of different anastomosis techniques in patients undergoing laparoscopic distal radical gastrectomy(LDRG)for gastric cancer.Methods A total of 58 patients who received LDRG in Fuding Hospital from March 2020 to March 2022 were selected.The patients were divided into observation group(29 cases)and control group(29 cases)by random number table method.The control group received Roux-en-Y anastomosis after surgery,while the observation group received non disconnecting Roux-en-Y anastomosis after surgery.The surgical indicators,postoperative complications,and quality of life of the two groups of patients were compared.Results The exhaust time of the observation group patients was shorter than that of the control group(P<0.05),and there was no significant difference in operation time,anastomosis time,hospital stay,intraoperative blood loss and number of lymph node dissection between the two groups(P>0.05).The incidence of ROUX stasis syndrome(RSS)in the observation group patients at 6 months after surgery was 3.45%,lower than the 27.59%in the control group(P<0.05),and there was no significant difference in the incidence of anastomotic hemorrhage,gastroesophageal reflux,anastomotic ulcer,anastomotic leakage and abdominal infection between 2 groups(P>0.05).The MOS item short from health survey(SF-36)scores of the two groups of patients were higher than those before surgery,and the postoperative observation group had higher SF-36 scale scores than the control group(P<0.05).Conclusion Using non disconnecting Roux-en-Y anastomosis after LDRG surgery can reduce the patient's exhaust time and the incidence of RSS,while not increasing other complications and improving the patient's quality of life.

关 键 词：腹腔镜远端胃癌根治术 ROUX-EN-Y吻合术 非离断Roux-en-Y吻合术 手术指标 并发症 生活质量 

分 类 号：R735[医药卫生—肿瘤]