摘要
目的评估全胃切除术后三种不同的消化道重建术式对患者生活质量的影响。方法1994年5月至2004年5月我们对96例全胃切除术患者分别采用了Orr式食管空肠RouxenY吻合术、P形食管空肠RouxenY吻合术及“6”字形间置空肠代胃术三种不同的消化道重建术式,并对三种术式患者术后并发症的发生率、术后2周与2个月的营养指标、饮食状况及消化道症状进行对比。结果三种消化道重建术式术后并发症发生率以“6”字型术组最高,Orr式术组居中,P形术组最低(11%、2.1%、0);术后2周与2个月的体重、总蛋白、白蛋白及血红蛋白水平在Orr式术组明显低于P形术组(P<0.05)及“6”字形术组(P<0.05);术后倾倒综合征(7%、0、0)、返流性食管炎(60%、4%、0)及营养不良(20%、0、0)的发生率Orr式术组最高,P形术组居中,“6”字形术组最低。结论P形RouxenY食管空肠吻合术操作更简便,患者术后营养状况好、生活质量高,是全胃切除后消化道重建较为理想的术式。
Objective To investigate the effect of three different digestive tract reconstruction on patient＇s living quality after total gastrectomy for gastric tumors. Methods From May 1994 to May 2004, three different types of digestive tract reconstruction were adopted in 96 cases of total gastrectomy. The complications, body weight, hemoglobin, total protein, albumin in serum at 2 week and 2 months post operation as well as nutrition, symptoms were analyzed. Results “6” type esophagojejunostomy was characteristic of higher complication rate compared with P-type group and Orr-type group （ 11% vs 0% vs 2. 1% ）. Patients＇ body weight, hemoglobin, total protein and albumin were significantly lower in Orr-type group than P-type group（ P 〈 0. 05 ） and 6 type group （P 〈 0. 05 ）. Patients in Orr-type group suffered from higher rate of reflux esophagitis （7% , 0% , 0% ） , dumping syndrome （ 60% , 4% , 0% ） and malnutrition （20%, 0%, 0% ） than P-type group and “ 6” type group. Conclusions P-type Roux-en-Y esophagojejunostomy is a procedure of choice for digestive tract reconstruction after total gastrectomy for patients with gastric tumors, in terms of better postoperative living quality and better nutrition state.
出处
《中华普通外科杂志》
CSCD
北大核心
2005年第10期654-656,共3页
Chinese Journal of General Surgery
关键词
胃肿瘤
胃切除术
消化道重建
Stomach neoplasms
Gastrectomy
Digestive tract reconstruction
