摘要
目的探讨全胃切除术后合理的消化道重建方式。方法自2006年1月—2008年7月,对44例全胃切除术分别采用Schlatter式及食管空肠Roux-en-Y式2种不同的消化道重建方式,对术中消化道重建时间,术后6个月患者自述症状,术后6个月患者并发症,术后6个月和24个月患者饮食情况、消化道症状和营养指标进行对比观察。结果 2种术式术中消化道重建时间差异无统计学意义(P>0.05)。术后6个月,Schlatter式术组患者返流性食管炎和营养不良的发生率明显高于食管空肠Roux-en-Y术组(P<0.05)。术后6个月患者自述术后症状,Schlatter式术组患者评分明显较Roux-en-Y组患者高(P<0.05)。术后6个月,2组患者体重增加、血红蛋白、血清总蛋白和血清白蛋白指标比较差异无显著性(P>0.05),但在术后24个月,空肠Roux-en-Y术组患者的上述指标有明显提高(P<0.05)。结论全胃切除术后采用食管空肠Roux-en-Y术,操作简单易行,能有效地防止反流性食管炎的发生,提高患者生活质量,可推荐为胃癌全胃切除后消化道重建的首选术式。
Objective To investigate the rationality of different types of digestive reconstruction after total gastrectomy.Methods From January 2006 to January 2005,two different types of digestive reconstruction were performed in 44 cases of total gastrectomy for gastric malignant tumor.The anastomotic time,symptoms,complications,food intake,digestive tract symptoms as well as the nutritional status at 6 months and 24 months after surgery were comparatively analyzed.Results There was no significant difference in the anastomotic time among two groups（P〉0.05）.Patients in Schlatter type group suffered from higher rate of reflux esophagitis and malnutrition than Roux-en-Y type group at 6 months after surgery（P〈0.05）.Patients in Schlatter type group suffered from higher rate of symptoms than Roux-en-Y type group at 6 months after surgery（P〈0.05）.Patients＇body weight increase,hemoglobin,total protein and albumin were no significant difference among two groups at 6 months after surgery（P〉0.05）,but those indexes were significantly higher in Roux-en-Y type group than Schlatter-type group at 24 months after surgery（P〈0.05）.Conclusion The Roux-en-Y type digestive reconstection after total gastrectomy can prevent the reflux esophagitis,improve quality of life and reduce complications,is a convenient procedure for digestive reconstruction after total gastrectomy.
出处
《医药论坛杂志》
2010年第17期10-12,16,共4页
Journal of Medical Forum
关键词
胃肿瘤
全胃切除术
消化道重建
Stomach neoplasms
Total gastrectomy
Digestive reconstruction
