腹腔镜下远端胃大部切除术中应用毕Ⅱ式吻合联合Braun吻合对远端胃癌患者预后的影响  

The Effect of Laparoscopic Distal Subtotal Gastrectomy with BillrothⅡAnastomosis and Braun Anastomosis on Prognosis of Distal Gastric Cancer

作　　者：闻愚 习成浩 王晖 WEN Yu;XI Chenghao;WANG Hui(The First Affiliated Hospital of Nanyang Medical College,Nanyang,473000)

机构地区：[1]南阳医学高等专科学校第一附属医院,473000

出　　处：《实用癌症杂志》2025年第3期459-462,478,共5页The Practical Journal of Cancer

摘　　要：目的 探究腹腔镜下远端胃大部切除术中应用毕Ⅱ式吻合联合Braun吻合对患者预后的影响。方法 随机选取96例远端胃癌患者,根据随机双盲法分组,对照组48例接受常规腹腔镜下远端胃大部切除毕Ⅱ式吻合手术治疗,观察组48例接受腹腔镜下辅助远端胃大部切除毕Ⅱ式吻合联合Braun吻合手术治疗,观察2组手术情况、术后营养状况、并发症与生活质量等。结果 观察组患者术中消化道重建操作时间、手术费用均高于对照组,患者术后住院时间短于对照组(P<0.05)。术后1个月、术后3个月观察组患者的PNI指数、总蛋白水平优于对照组。与对照组的BMI指标比较,观察组术后1个月则更低(P<0.05);但术后3个月观察组BMI下降与对照组比较,P>0.05。观察组与对照组并发症发生率(4.17%vs 20.83%)比较,差异有统计学意义(P<0.05)。随访3个月评价患者NHP水平,观察组除睡眠外,其余五项(患者的躯体活动、疼痛水平、患者社会功能、患者的精力水平、情感反应)评分均优于对照组(P<0.05),并且NHP量表的6个维度评分中,随访3个月后的评分均显著低于入院时的评分(P<0.05)。结论 远端胃癌患者在腹腔镜下进行远端胃大部切除毕Ⅱ式吻合联合Braun吻合治疗,有助于促进患者术后的快速康复,并对改善患者的营养状况具有积极作用,同时可减少患者术后住院期间并发症的发生风险,提高生活质量水平;但联合以上两种技术无疑会增加患者经济负担,临床可根据实际情况考虑选择合理方式治疗。Objective To investigate the prognostic effect of laparoscopic BiⅡanastomosis combined with Braun anastomosis on subtotal gastrectomy for distal gastric cancer.Methods 96 patients with distal gastric cancer were randomly selected and divided into 2 groups according to random double-blind method.48 patients in the control group received conventional laparoscopic distal subtotal gastrectomy with typeⅡanastomosis,while 48 patients in the observation group received laparoscopically assisted distal subtotal gastrectomy with typeⅡanastomosis combined with Braun anastomosis.The operation status,postoperative nutritional status,complications and quality of life of the 2 groups were observed.Results The operation time and operation cost of digestive tract reconstruction in the observation group were higher than those in the control group,and the postoperative hospitalization time was shorter than that in the control group(P<0.05).The PNI index and total protein of the observation group were lower than that of the control group 1 month and 3 months after operation.Compared with the control group,the BMI index of the observation group was lower 1 month after operation(P<0.05).However,the BMI of observation group decreased 3 months after operation compared with the control group,P>0.05.There was significant difference in the incidence of complications between the observation group and the control group(4.17%vs 20.83%)(P<0.05).After 3 months of follow-up,the NHP level of the patients was evaluated.Except sleep,the scores of the other five evaluations(physical activity,pain level,social function,energy level,emotional response)of the observation group were superior to those of the control group(P<0.05).In addition,among the 6 dimensions of NHP scale,The scores after 3 months of follow-up were significantly lower than those at admission(P<0.05).Conclusion Laparoscopic distal subtotal gastrectomy typeⅡanastomosis combined with Braun anastomosis in patients with distal gastric cancer can promote rapid postoperative recove

关 键 词：腹腔镜手术 远端胃癌 胃大部切除术 毕Ⅱ式吻合 Braun吻合 

分 类 号：R735.2[医药卫生—肿瘤]