摘要
目的 探讨胰管-空肠导管对黏膜吻合术和捆绑式胰肠套入吻合术在胰十二指肠切除术(PD)中的效果。方法 64例行胰十二指肠切除术的患者,按入院顺序分为A组和B组,各32例。A组行胰管-空肠导管对黏膜吻合术治疗, B组行捆绑式胰肠套入吻合术治疗。比较两组手术相关指标(手术时间、术中出血量、术中输血量、术后排气时间、进流食时间、拔管时间、住院时间)、并发症发生情况及术后生活质量评分。结果 B组手术时间(240.81±59.25)min明显短于A组的(269.78±46.58)min,差异有统计学意义(P<0.05);B组术中出血量、术中输血量、术后排气时间、进流食时间、拔管时间、住院时间分别为(360.00±30.85)ml、(1.16±0.32)U、(4.56±1.29)d、(6.16±1.19)d、(5.78±1.00)d、(16.25±1.30)d,与A组的(350.81±29.77)ml、(1.25±0.36)U、(4.28±1.28)d、(5.81±0.82)d、(5.59±1.07)d、(16.47±1.77)d比较,差异无统计学意义(P>0.05)。B组并发症发生率为37.50%,低于A组的37.50%,但差异无统计学意义(P>0.05)。B组总体健康、生理功能、生理职能、躯体疼痛、活力、社会功能、情感职能及精神健康评分分别为(70.06±3.94)、(69.34±4.10)、(70.44±4.71)、(70.72±4.51)、(69.28±4.64)、(70.03±4.72)、(70.38±4.41)、(70.03±4.55)分,与A组的(69.50±4.68)、(70.22±4.51)、(69.13±3.82)、(68.84±3.94)、(70.28±3.95)、(69.53±3.90)、(69.19±4.18)、(69.53±4.10)分比较,差异无统计学意义(P>0.05)。结论 针对行胰十二指肠切除术的患者,胰管-空肠导管对黏膜吻合术和捆绑式胰肠套入吻合术均有较好的治疗效果,患者并发症发生率及术后生活质量无明显差异,但是捆绑式胰肠套入吻合术的手术时间明显缩短,临床可依据患者个性化情况选择胰肠吻合术式。
Objective To discuss the effect of pancreatic duct-to-jejunum mucosa anastomosis and binding pancreaticojejunostomy in pancreaticoduodenectomy(PD). Methods A total of 64 patients who underwent pancreaticoduodenectomy were divided into group A and group B according to the order of admission,with 32 cases in each group. Group A was treated with pancreatic duct-to-jejunum mucosa anastomosis, and group B was treated with binding pancreaticojejunostomy. Both groups were compared in terms of surgeryrelated indicators(operation time, intraoperative blood loss, intraoperative blood transfusion volume, postoperative exhaust time, liquid food intake time, extubation time, hospitalization time), occurrence of complications, and postoperative quality of life scores. Results The operation time(240.81±59.25) min of group B was significantly shorter than(269.78±46.58) min of group A, and the difference was statistically significant(P<0.05). In group B, the intraoperative blood loss, intraoperative blood transfusion volume, postoperative exhaust time,liquid food intake time, extubation time, and hospitalization time were(360.00±30.85) ml,(1.16±0.32) U,(4.56±1.29) d,(6.16±1.19) d,(5.78±1.00) d, and(16.25±1.30) d, and those were(350.81±29.77) ml,(1.25±0.36) U,(4.28±1.28) d,(5.81±0.82) d,(5.59±1.07) d, and(16.47±1.77) d in group A, and the differences were not statistically significant(P>0.05). The complication rate of group B was 37.50%, which was lower than 37.50%of group A, but the difference was not statistically significant(P>0.05). The scores of overall health, physical functioning, role-physical, physical pain, vitality, social function, emotional function and mental health of group B were(70.06±3.94),(69.34±4.10),(70.44±4.71),(70.72±4.51),(69.28±4.64),(70.03±4.72),(70.38±4.41),and(70.03±4.55) points, and those were(69.50±4.68),(70.22±4.51),(69.13±3.82),(68.84±3.94),(70.28±3.95),(69.53±3.90),(69.19±4.18), and(69.53±4.10) points of group A, and the differences were not statistically significant(P
作者
吴涛
杨柳
张杨
WU Tao;YANG Liu;ZHANG Yang(Department of Hepatobiliary Surgery,Luzhou People's Hospital,Luzhou 646000,China)
出处
《中国实用医药》
2022年第11期14-17,共4页
China Practical Medicine
