管状胃对食管癌切除术后患者生活质量的影响

Effects of Tubular Stomach Resection on Quality of Life of Esophageal Cancer Patients

目的观察管状胃用于食管癌切除术患者对其术后生活质量的影响。方法选取80例行食管癌切除术的患者,并随机分为2组,各40例。观察组40例在术后采用管状胃食管吻合术,对照组40例在术后采用全胃食管吻合术,观察比较2组患者并发症发生率。对2组患者随访1年,并对2组患者术后3周、术后半年及术后1年日常生活、社会影响、情感活动、一般情况及治疗相关症状等5个方面进行生活质量评估。结果观察组术后1例(2.50%)发生吻合口瘘,无1例发生吻合口出血、反流性食管炎及胸胃综合征,1例伤口感染(2.50%),1例喉返神经损伤(2.50%);对照组2例(5.00%)发生吻合口瘘,1例(2.50%)发生吻合口出血,1例(2.50%)肺部感染,5例(12.50%)发生反流性食管炎,6例(15.00%)发生胸胃综合征。观察组反流性食管炎及胸胃综合征发生率明显低于对照组(P<0.05),其他并发症无显著差异(P>0.05)。2组患者术后3周生活质量评分无显著差异;但术后半年及术后1年,观察组生活质量评分分别为(89.85±7.98)分、(90.28±10.54)分,对照组分别为(65.68±8.12)分、(65.15±7.12)分,观察组生活质量评分均明显高于对照组(P<0.05)。结论管状胃用于食管癌切除术后,相比传统的全胃食管吻合术,可降低术后胸胃综合征及反流性食管炎的发生,可提高患者短期内生活质量。

Objective To observe the gastric tube for esophageal resection on quality of life after surgery. Methods 80 patients with routine esophageal resection were randomly divided into 2 groups ,40 cases using tubular esophagogastric anastomosis as the observation group, 40 cases using full gastroesophageal anastomosis as the control group, the incidence of complications were were observed and compared, and visit 2 groups of patients 1 year after surgery. 3-week, 6-month and 1-year postoperative daily life, social impact, emotional activity, and treatment-related symptoms of patients was evaluated. Results There were 1 anastomotic leakage（2.50% ）,no anastomotic bleeding, reflux esophagitis and chest and stomach syndrome, 1 wound infection （2.50%） and 1 recurrent laryngeal nerve injury （2.50%） in the observation group ;there were 2 anastomotic fistula（5.00% ） , 1 anastomotic bleeding（2.50% ）, 1 lung infection （ 2.50% ）, 5 reflux esophagitis （ 12.50% ） and 6 thoracic stomach syndrome （ 15.00% ） in the control group. Reflux esophagitis and thoracic stomach syndrome of the observation group was significantly low- er than that of the control group （ P 〈 0.05 ）, other complications had no significant difference （ P 〉 0.05 ）. 3-week QOL had no significant difference ,6-month and 1-year quality of life scores of the observation group were （89.85 ＋ 7.98 ） points, （90.28 ＋ 10.54） points,the control group were （65.68 -＋ 8.12） points, （65.15 _＋ 7.12） points,the observation group had significantly higher quality of life scores （ P 〈 0.05 ）. Conclusion Tubular gastric resection for esophageal cancer may reduce postoperative chest syndrome and reflux esophagitis, and it can improve the quality of life in patients in short term.