全胃切除术后两种常用消化道重建方式的比较

Two Common after Total Gastrectomy Comparative Digestive Tract Reconstruction

目的探讨全胃切除术合理的消化道重建方式。方法回顾性分析55例行全胃切除术的患者,其中以P型空肠袢Roux-en-Y吻合术重建消化道者25例,以空肠间置代胃吻合术重建消化道者30例。比较术后6个月时患者营养状态。结果术后6个月空肠间置代胃吻合术组体重下降程度明显低于P型空肠袢Roux-en-Y吻合术组,差异有统计学意义(P<0.05)。术后6个月血浆总蛋白、白蛋白水平变化,空肠间置代胃吻合术组均升高,而P型空肠袢Roux-en-Y吻合术组分别降低,差异有统计学意义(P<0.05)。结论改良空肠间置代胃吻合术有利于维持患者术后生活质量,在每天进食量及体重恢复方面改良空肠问置代胃吻合术优于P型空肠袢食管空肠Roux-en-Y吻合术。

Objective Reasonable total gastrectomy digestive tract reconstruction.Methods A retrospective analysis of 55 routine patients with total gastrectomy,in which P-type jejunal loop Roux-en-Y anastomosis in 25 cases reconstruction of the digestive tract to jejunum anastomosis between the home on behalf of the reconstruction of digestive tract in 30 cases.6 months after surgery compared nutritional status of patients.Results 6 months after jejunal anastomosis between the group home on behalf of the extent of weight loss was significantly lower than the P-type jejunal Roux-en-Y loop anastomosis group,the difference was statistically significant（P0.05）.6 months after total plasma protein,albumin levels,jejunum anastomosis between the home on behalf of the group were increased.The P-type jejunal Roux-en-Y loop anastomosis group were reduced significantly（P0.05）.Conclusion The modified jejunum interposition on behalf of the anastomosis to help maintain postoperative quality of life,daily food intake and body weight in rehabilitation of home improvement question on behalf of the jejunum anastomosis is superior to P-type jejunal loop esophagus jejunum Roux-en-Y anastomosis.