全胃切除空肠P袢代胃术治疗胃底贲门癌的临床疗效  

Clinical efficacy of total gastrectomy for jejunal P-stomach surgery for gastric cardia cancer

作　　者：崔继承[1] 谢军[1] 王海连[1] CUI Ji-cheng;XIE Jun;WANG Hai-lian(Fengxian People's Hospital of Xuzhou City,Jiangsu Province,Xuzhou 221700,China)

机构地区：[1]江苏省徐州市丰县人民医院,江苏徐州221700

出　　处：《现代医学与健康研究电子杂志》2018年第21期21-24,共4页Modern Medicine and Health Research

摘　　要：目的探讨全胃切除空肠P袢代胃术治疗胃底贲门癌的临床疗效。方法选取2012年5月—2017年5月在江苏省徐州市丰县人民医院收治的80例胃底贲门癌患者,随机分为观察组和对照组,每组40例。对照组使用常规近侧胃切除术治疗,观察组使用全胃切除空肠P袢代胃术治疗。比较两组患者的各项手术指标、术后进食情况、术后各营养指标情况、术后并发症发生率、转移复发及生存情况。结果观察组手术时间、术中出血量、切口愈合时间、住院时间与对照组比较,差异无统计学意义(P> 0.05);观察组术后3个月、6个月、12个月的胃肠排空时间明显长于对照组,而每次饮食量明显高于对照组,每日饮食次数明显少于对照组(P <0.05);观察组术后3个月、6个月、12个月的血红蛋白、白蛋白、总蛋白水平明显高于对照组(P <0.05);观察组术后胃排空障碍、倾倒综合征、营养不良、食欲不振、胸腔感染、膈下脓肿、肠梗阻等并发症发生率明显低于对照组(P <0.05);观察组1年内复发率、转移率、死亡率明显低于对照组(P <0.05)。结论全胃切除空肠P袢代胃术治疗胃底贲门癌的临床疗效显著,能够保留消化系统储存食物及蠕动的功能,延迟胃排空,增强营养吸收,且并发症发生率低,复发及转移率低,术后生活质量高,具有积极的临床意义。Objective To investigate the clinical efficacy of total gastrectomy for jejunal P-stomach surgery for gastric cardia and gastric cardia cancer.Methods Eighty patients with gastric cardia cancer admitted to Fengxian People’s Hospital of Xuzhou City,Jiangsu Province from May 2012 to May 2017 were randomly divided into observation group and control group,with 40 cases in each group.The control group was treated with conventional proximal gastrectomy,and the observation group was treated with total gastrectomy for jejunum P.The surgical indexes,postoperative feeding,postoperative nutritional status,postoperative complication rate,metastasis recurrence and survival were compared between the two groups.Results There was no significant difference in the operation time,intraoperative blood loss,incision healing time and hospitalization time between the observation group and the control group(P>0.05).The observation group had gastrointestinal findings at 3 months,6 months and 12 months after operation.The emptying time was significantly longer than that of the control group,and the amount of each diet was significantly higher than that of the control group.The daily diet was significantly less than the control group(P<0.05).The observation group was 3 months,6 months,and 12 months after the operation.The levels of hemoglobin,albumin and total protein were significantly higher than those in the control group(P<0.05).Postoperative gastric emptying disorder,dumping syndrome,malnutrition,loss of appetite,chest infection,underarm abscess,intestinal obstruction and other complications were observed in the observation group.The incidence was significantly lower than that of the control group(P<0.05).The recurrence rate,metastasis rate and mortality of the observation group were significantly lower than those of the control group within 1 year(P<0.05).Conclusion The general curative effect of total gastro-intestinal jejunal P-stomach surgery for gastric cardia cancer is significant.It can preserve the function of food and peris

关 键 词：胃底贲门癌 全胃切除空肠P袢代胃术 常规近侧胃切除术 临床疗效 

分 类 号：R735.2[医药卫生—肿瘤]