【摘要】 目的探讨根治性近侧胃大部切除术后合理的消化道重建方法及其对术后营养状况的影响;方法回顾性分析食管残胃间空肠间置组(观察组)32例和食管残胃吻合组(对照组)30例的胃癌病人,分别观察两组手术时间、手术风险,术后3、6个月反流性食管炎发生情况及前白蛋白、体重变化情况。结果观察组手术时间(163.9±18.4)min,对照组手术时间(137.7±18.9)min,两组比较差异具有统计学意义;两组病人术后吻合口瘘、血液感染、导管相关感染、肺部感染情况比较,差异无统计学意义;两组术后第2、4、6 d全身炎性反应综合征发生率及CRP比较,差异均无统计学意义。观察组术后3、6个月反流严重程度评分明显低于对照组,两组比较差异具有统计学意义;观察组术后体重变化情况评分,明显低于对照组,两组比较差异具有统计学意义。观察组术后3、6个月前白蛋白高于对照组,两组差异有统计学意义(P<0.05)。结论空肠间置术手术时间相对延长,但并未增加术后并发症,术后反流症状减轻,生活质量明显改善,体重及营养恢复较快,是近端胃癌根治术后较合理的消化道重建方法。更多还原

【Abstract】 Objective To discuss the ideal Methods of digestive tract reconstruction and Influence of nutrition after radical proximal gastrectomy.Methods 32 Patients in the experimental group treated by jejunal interposition technique;other 30 patients received gastroesophagostomy.The operation time,operation risk,the occurrence of reflux esophagitis and the nutritional status 3,6month after operation were evaluate.Results The difference of the Operation time(experimental grou,(163.9 ± 18.4)mi;control grou,(137.7 ± 18.9)min)between two groups were statistically significan;there are no difference of operation risk,CRP 2、4、6day,SIRS 2、4、6day of postoperative between the two group;The difference of the occurrence of reflux esophagitis and the nutritional status 3、6month and Prealbumin 3、 6months after operation between two groups were statistically significantConclusion The jejunal interposition technique after radical proximal gastrectomy is an idealMethods of digestive tract reconstruction. The postoperative complications of the jejunal interposition group were not improv. It can improve the quality of lif. Modified double tracks anastomosis jejunal interposition technique for radical proximal gastrectomy showed better outcomes than esophagus-remnant stomach direct anastomosis更多还原