摘要
目的 探讨全胃切除术与近端胃癌根治间置空肠术对进展期近端胃癌(肿瘤直径>3cm)患者术后并发症、营养状况和生活质量的影响.方法 回顾性分析2002年1月-2008年12月南方医科大学中西医结合医院收治的近端胃癌患者85例,其中全胃切除术(对照组)40例,近端胃癌根治间置空肠术(试验组)45例,调查术后营养状况、反流性食管炎发病率、术后胆囊结石发病率、5年生存率和术后生活质量.结果 试验组和对照组5年生存率差异无显著统计学意义[55.6%(25/45)vs52.5%(21/40),P>0.05].试验组术后反流性食管炎发病率显著低于对照组[11.1%(5/45)vs22.5%(9/40),P=0.042].试验组术后5年累计胆囊结石发病率显著低于对照组[13.3%(6/45)vs17.5%(7/40),P=0.038].试验组术后血红蛋白、白蛋白、维生素B12和铁蛋白均显著高于对照组[(142.2±8.6)vs(128.4±8.4),(41.3±5.8)vs(35.9±3.8),(271.5±49.7)vs(184.5±24.6),(220.2±59.7)vs(170.2±27.6),P值分别为0.036、0.024、0.032、0.026].试验组患者术后饮食情况和劳动情况均显著优于对照组(P值分别为0.042和0.048).结论 近端胃癌根治间置空肠术不影响进展期近端胃癌(肿瘤直径>3cm)患者5年生存率,可以降低术后反流性食管炎和胆囊结石发病率,改善术后营养状况和生活质量.
Objective To compare complication,nutritional status and quality of life between total gastrectomy and jejuna interposition after proximal radical gastrectomy in patients with advanced proximal gastric carcinoma.Methods Eighty-five patients with proximal stomach cancer were enrolled from Jan.2002 to Dec.2008,total gastrectomy group(Control group) had 40 cases,jejuna interposition after proximal radical gastrectomy(Experimental group) included 45 cases.Nutritional status,incidence of reflux esophagitis and cholecystolithiasis,5-year survival rate,quality of life were investigated.Results There was no significant difference in 5-year survival rate between two groups(P 〉 0.05).Incidence of reflux esophagitis in Experimental group was significantly lower than that in Control group(P =0.042).Incidence of cholecystolithiasis in Experimental group was significantly lower than that in Control group (P =0.038).Hemoglobin,albumin,vitamin B12 and ferritin in Experimental group were significantly higher than those in Control group[(142.2 ±8.6) vs (128.4 ±8.4),(41.3 ±5.8) vs (35.9 ±3.8),(271.5 ± 49.7) vs (184.5 ± 24.6),(220.2 ± 59.7) vs (170.2 ± 27.6),P =0.036,0.024,0.032,0.026].Diet and labor in Experimental group were better than those in Control group (P =0.042,0.048).Conclusion Jejuna interposition after proximal radical gastrectomy decrease incidences of reflux esophagitis and cholecystolithiasis,improve nutritional status and quality of life.
出处
《国际外科学杂志》
2014年第7期470-473,共4页
International Journal of Surgery
关键词
胃切除术
近端胃癌根治间置空肠术
手术后并发症
营养状况
生活质量
Gastrectomy
Jejuna interposition after proximal radical gastrectomy
Postoperative complications
Nutritional status
Quality of life