【摘要】 目的分析胃癌患者全胃切除术后3种空肠代胃消化道重建术式的临床效果。方法将43例胃癌患者按全胃切除术后重建消化道方式的不同,分为Roux-en-Y型P空肠袢食管吻合术组(R组,16例)、Roux-en-Y型J形空肠贮袋食管吻合术组(JP-R组,12例)及间置空肠贮袋食管吻合术组(IP组,15例)。比较3种术式组患者的术后死亡率、并发症发生率、进食后症状、单餐的进食量、体重和血清营养指标以及胃排空时间。结果JP-R组和IP组的术后死亡率和并发症发生率与R组相比,差异无显著性意义(P>0.05)。JP-R组和IP组较R组能显著提高进食量和增加体重,部分血清营养指标明显改善,胃排空时间亦延长(P<0.05)。而JP-R组和IP组之间差异无显著性意义。结论Roux-en-Y型J形空肠贮袋食管吻合术与间置空肠贮袋食管吻合术,是胃癌行全胃切除术后消化道重建的较理想术式,能明显改善患者术后的生活质量。更多还原

【Abstract】 Objective To investigate the efficacy of three different methods of reconstruction after total gastrectomy for gastric cancer. Methods Forty three cases respectively receiving Roux en Y type of ρ loop esophagojejunostomy(group R, n=16), J pouch esophagojejunostomy(group JP R, n=12) or J pouch interposition esophagojejunostomy (group IP, n=15) were retrospectively studied. The post operative mortality, morbidity, postprandial symptoms, food intake, weight loss, serum nutritional parameters and emptying time of the gastric substitute were respectively evaluated. Results The post operative mortality and morbidity rates were similar among these three groups (P >0.05). As compared with R group, the food intake volume in a single meal, body weight increase (BWI), and serum nutritional parameters were improved, while emptying time of the gastric substitute was prolonged both in JP R and IP groups (P< 0.05), but there was no significant difference between JP R group and IP group. Conclusion JP R and IP operation are valuable procedures after total gastrectomy for gastric cancer, which can improve the quality of life.更多还原