兩種消化道重建術式對胃癌影響的臨床探討

聶煒

[摘要] 目的 對比分析全胃切除術后功能性間置空腸代胃術與Roux-en-Y術兩種消化道重建方式的術后患者療效。方法 隨機選擇該院于2011年2月—2013年2月醫治的70例因胃癌進行了全胃切除手術的患者作為研究對象，分為觀察組和對照組各35例。觀察組利用食管空腸吻合以及空腸側側吻合術為患者進行消化道重建，對照組則采用P形空腸袢空腸食管Roux-en-Y吻合術手術對消化道進行重建。觀察并記錄兩組患者1年后的血紅蛋白、白蛋白、總蛋白、體質量、并發癥以及每天的進食次數數據情況變化。結果 一年之后，觀察組與對照組患者的白蛋白、血紅蛋白、總蛋白值均接近正常指數，兩組數據之間比較，差異無統計學意義（P>0.05）；而兩組患者的進食次數和體質量對比上，觀察組明顯優于對照組。兩組相比較差異具有統計學意義（P<0.05）。兩組患者的術后并發癥，對照組早飽癥比例為14.3%，傾倒綜合征占11.4%，反流性食道炎為8.5%；觀察組的指數分別為5.7%、2.8%、2.8%，相比較而言觀察組并發癥例數明顯少于對照組，兩組相比較差異具有統計學意義（P<0.05）。 結論 綜上所述，兩種手術方式相比較，食管空腸吻合以及空腸側側吻合術對于胃癌需重建消化道患者，不僅能夠促使血蛋白各項指標迅速恢復正常，增加進食次數與體質量，而且術后患者并發癥較少，及時有效的治愈患者消化道疾病，臨床可對其進行推廣應用。

[關鍵詞] 消化道重建；胃癌；術式

[中圖分類號] R735.2 [文獻標識碼] A [文章編號] 1674-0742（2015）05（a）-0074-02

Two kinds of Digestive Tract Reconstruction Surgery Clinical Observation of the Impact of Gastric Cancer

NIE Wei

Heilongjiang agricultural reclamation red xinglong administration center hospital surgical oncology，Heilongjiang，155811 China

[Abstract] Objective To comparison and analysis between functional after total gastrectomy jejunum generation stomach insertion.we and Roux en - Y two types of the digestive tract reconstruction of the postoperative patients with curative effect. Methods selecting 70 patients from 2011 February to 2013 February in our hospital with gastric cancer in our hospital to heal for a full stomach surgery patients as the research object， is divided into observation group and control group （n=35）.Observation group with esophagus jejunum anastomosis and jejunum anastomosis of lateral side for patients with digestive tract reconstruction， control group adopts P form loops of jejunum jejunum anastomosis of esophageal Roux en - Y surgery on the digestive tract reconstruction. Observe and record two groups of patients after 1 years of hemoglobin， albumin， total protein，body weight，complications and every day.Results A year later， groups of patients with serum albumin， hemoglobin， total protein in the observation group and the control values were close to the normal index， no significant difference between the two groups of data（P<0.05）， the difference was not statistically significant； while the two groups of patients with eating frequency and weight comparison， the observation group was significantly better than the control group. The comparison of the two groups is significantly different， with statistical significance （P< 0.05）. Two groups of patients with postoperative complications， early satiety in the control group was 14.3%， dumping syndrome accounted for 11.4%， reflux esophagitis was 8.5%； the observation group index were 5.7%， 2.8%， 2.8%， compared in terms of complications in the observation group were significantly less than the control group， compared the two groups differed significantly， with statistical significance （P< 0.05）. Conclusion To sum up， two kinds of operation modes are compared， and the jejunum anastomosis for reconstruction of side to side anastomosis of gastric cancer in patients with digestive tract， not only can promote the blood protein targets quickly returned to normal， to increase the frequency of eating and body weight， and the postoperative patients with fewer complications， timely and effective cure for patients with digestive tract disease， clinical application.

[Key words] Digestive tract reconstruction；Gastric cancer；Operation

在我國，胃癌是各種惡性腫瘤居首位的，大多是年齡50歲以上，男女的發病率比值為2：1。因此，全胃切除術的消化道重建一直都是胃癌治療領域的研究熱點之一[1-3]。我國主要治療手段是外科手術，全胃切除手術成為了患者必要的選擇?？墒窃谑中g之后，胃的功能失去，給患者心理上與生理上影響很大，所以全胃切除手術之后，關鍵是選擇好的消化道的重建術式，保留食物儲袋使食物通道具有連續性是理想的消化道重建，主要是為了防止食管炎里的食物反流，并且促進袋內的食物向小腸排空。該……