摘要
目的:探讨两种消化道重建方式对Siewert Ⅱ、Ⅲ型食管胃结合部腺癌切除术患者预后的影响。方法:选择2018年8月-2020年10月荆州市第二人民医院收治的124例Siewert Ⅱ、Ⅲ型食管胃结合部腺癌切除术患者为研究对象,根据分层区组随机法将其分为观察组和对照组,每组62例。观察组进行空肠残胃-空肠双通道吻合,对照组进行食管残端单通道吻合。比较两组术后恢复指标以及各时间段体重、营养指标、胃肠消化功能,统计住院期间并发症发生情况。结果:两组手术时间、首次通气时间、术后肛门排气时间、消化道重建时间、住院时间比较,差异均无统计学意义(P>0.05)。经重复测量分析,两组单次进食量、胃泌素、胃蛋白酶原Ⅰ/Ⅱ的主体内效应、主体间效应比较,差异均有统计学意义(P<0.05)。两组术后2个月,单次进食量有所降低,但术后4、6个月均有所回升,术后2、4、6个月,两组胃泌素较术前均有所升高,胃蛋白酶原Ⅰ/Ⅱ均有所降低(P<0.05);观察组术后各时间段单次进食量、胃泌素均高于对照组,胃蛋白酶原Ⅰ/Ⅱ均低于对照组(P<0.05)。观察组术后6个月前白蛋白、白蛋白、总蛋白水平均高于对照组(P<0.05)。经重复测量分析,两组体重的主体内效应、主体间效应比较,差异均有统计学意义(P<0.05);两组术后2个月,体重均有所降低,但术后4、6个月体重均有所回升(P<0.05);而观察组术后各时间段体重均高于对照组(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:对Siewert Ⅱ、Ⅲ型食管胃结合部腺癌切除术患者开展空肠残胃-空肠双通道吻合,能更好改善术后营养状况,且不影响残胃分泌功能,安全性较高。
Objective:To explore the effect of two methods of digestive tract reconstruction on the prognosis of Siewert type Ⅱ,Ⅲ esophagogastric junction adenocarcinoma.Method:A total of 124 patients with Siewert type Ⅱ,Ⅲ esophagogastric junction adenocarcinoma treated in Jingzhou Second People’s Hospital from August 2018 to October 2020 were selected as the study subjects,they were randomly divided into observation group and control group according to stratified zone method,62 cases in each group.The observation group received jejunum residual stomach-jejunum double-channel anastomosis,the control group received esophageal residual single channel anastomosis.The postoperative recovery indexes,body weight,nutritional indexes and gastrointestinal digestive function at each time period were compared between the two groups,and the incidence of complications during hospitalization was counted.Result:There were no significant differences in operation time,first ventilation time,postoperative anal exhaust time,digestive tract reconstruction time and hospital stay between the two groups (P>0.05).After repeated measurement analysis,the comparison of intra-and interbody effects of single feed intake,gastrin and pepsin ogen Ⅰ/Ⅱ in the two groups,the differences were statistically significant (P<0.05).Single feed intake in both groups decreased 2 months after surgery,but increased 4 and 6 months after surgery,gastrin increased 2,4 and 6 months after surgery,and pepsin ogen Ⅰ/Ⅱ decreased (P<0.05);single feed intake and gastrin in the observation group were higher than those in the control group,and pepsin ogen Ⅰ/Ⅱ were lower than those in the control group (P<0.05).The levels of albumin,albumin and total protein in the observation group were higher than those in the control group 6 months after operation (P<0.05).After repeated measurement analysis,the intra-subjective effect and intersubjective effect of body weight were compared between the two groups,the differences were statistically significant (P<0.05),both
作者
廖汉琪
姜耕
唐羿
LIAO Hanqi;JIANG Geng;TANG Yi(Jingzhou Second People’s Hospital,Hubei Province,Jingzhou 434000,China;不详)
出处
《中国医学创新》
CAS
2022年第6期55-59,共5页
Medical Innovation of China
关键词
消化道重建
Siewert型
食管胃结合部
腺癌切除术
预后
Digestive tract reconstruction
Siewert type
Esophagogastric junction
Adenocarcinoma resection
Prognosis
