腹腔镜近端胃切除术后双通道重建与食管胃吻合术治疗早期胃上部癌的疗效及对营养状况、生活质量的影响  

Effect of double-tract reconstruction and esophagogastrostomy after proximal gastrectomy on early upper gastric cancer and its influence on nutritional status and quality of life

作　　者：张凯[1] 潘宁波 吴孟龙 ZHANG Kai;PAN Ning-bo;WU Meng-long(Department of Gastrointestinal Surgery,The First People's Hospital of Guangyuan City,Guangyuan Sichuan 628017,China)

机构地区：[1]广元市第一人民医院胃肠外科,四川广元628017

出　　处：《临床和实验医学杂志》2024年第21期2305-2308,共4页Journal of Clinical and Experimental Medicine

基　　金：四川省医学科研课题计划(编号:21000136)。

摘　　要：目的比较腹腔镜近端胃切除术(LPG)后双通道重建(DT)与食管胃吻合术(EG)治疗早期胃上部癌的疗效及对营养状况、生活质量的影响。方法将2022年1月至2024年3月广元市第一人民医院收治的120例早期胃上部癌患者纳入本次回顾性研究。按照治疗方式不同分组:67例患者接受LPG后EG治疗,纳入EG组,53例患者接受LPG后DT治疗,纳入DT组。比较两组的手术结果(术中出血量、手术时间、住院时间和术后首次进食时间)、并发症发生情况、术后1个月的营养状况(总蛋白、白蛋白和血红蛋白)及生活质量[欧洲癌症研究与治疗组织生命质量测定量表(QLQ-C30)和胃癌模块生活质量问卷(QLQ-ST022)]。结果两组的术中出血量、住院事件和术后首次进食时间比较,差异均无统计学意义(P>0.05),DT组的手术时间为(163.24±32.60)min,较EG组[(138.02±29.41)min]显著延长,差异有统计学意义(P<0.05)。DT组的反流性食管炎发生率为9.43%,显著低于EG组(23.88%),差异有统计学意义(P<0.05)。DT组术后1个月的总蛋白、白蛋白和血红蛋白分别为(65.60±6.14)、(57.21±5.37)和(122.35±9.44)g/L,均显著高于EG组[(60.24±5.97)、(52.36±5.09)和(117.62±8.77)g/L],差异均有统计学意义(P<0.05)。两组术后1个月的QLQ-C30评分和QLQ-STO22总分比较,差异均无统计学意义(P>0.05)。结论LPG后DT的手术效果良好,与LPG后EG相比,其在术后并发症、营养状况方面具有显著优势。LPG后DT与LPG后EG治疗两种方式对术后质量差异不大,无显著优势。Objective To compare the efficacy of double-tract reconstruction(DT)and esophagogastrostomy(EG)after laparoscopic proximal gastrectomy(LPG)in the treatment of early upper gastric cancer and its influence on nutritional status and quality of life.Methods A total of 120 patients with early upper gastric cancer admitted to the First People's Hospital of Guangyuan City from January 2022 to March 2024 were included in this retrospective study.According to different treatment methods,67 patients received EG treatment after LPG and were included in the EG group,and 53 patients received DT treatment after LPG and were included in the DT group.The surgical results(including intraoperative blood loss,operation time,hospital stay and first postoperative feeding time),the occurrence of complications,the nutritional status(including total protein,albumin and hemoglobin)and the quality of life[European organization for research and treatment of cancer quality of life questionnaire-core 30(QLQ-C30)and quality of life questionnaire-ST022(QLQ-STO22)]were compared.Results There were no statistically significant differences in intraoperative blood loss,hospitalization events and postoperative first feeding time between the two groups(P>0.05);the operative time of the DT group was(163.24±32.60)min,which was longer than that of the EG group[(138.02±29.41)min],the difference was statistically significant(P<0.05).The incidence of reflux esophagitis in the DT group was 9.43%,which was lower than that in the EG group(23.88%),the difference was statistically significant(P<0.05).The levels of total protein,albumin and hemoglob in the DT group at 1 month after surgery were(65.60±6.14),(57.21±5.37)and(122.35±9.44)g/L,respectively,which were higher than those of the EG group[(60.24±5.97),(52.36±5.09)and(117.62±8.77)g/L],the differences were statistically significant(P<0.05).There were no statistically significant differences in the QLQ-C30 score and QLQ-STO22 total score between the two groups(P>0.05).Conclusion The surgical effect of

关 键 词：腔镜近端胃切除术 双通道重建 食管胃吻合术 早期胃上部癌 营养 

分 类 号：R735.2[医药卫生—肿瘤]