全胃切除术后不同代胃术式的比较

The comparison of different reconstructive methods of alimentary canal for total gastrectomy

目的 比较全胃切除术后不同消化道重建术式的临床应用效果。方法 两组患者分别行Ｐ式Roux－en-Y食管－空肠吻合术（P式组）和Kuroyangai法Roux－en-Y食管－空肠吻合术（K法组），对各自的营养状态进行对比研究。结果 P式组手术前后体重、血红蛋白和血浆总蛋白下降程度分别为（5．65±23）kg、（2．14±16）g／L、（0．95±0．7）g／L；K法组则分别为（4．29±1．6）kg、（1.1l±）.8）g／L、（0.96±0.9）g／L。经统计学t检验处理，两组患者的上述差异无显著性（P＞0．05）。结论 与传统的P式Roux－en-Y食管－空肠吻合术相比上法Roux－en－Y食管－空肠吻合术手术前后全身营养状况的变化方面均不逊于前者，且操作更简便，不失为一种较好的全胃切除术消化道重建术式。

Objective To compare the clinical effects of different reconstructive alimentary canal for total gastrectomy. Methods The patients were divided into P loop/Roux-en-Y and Kuroyangai/ Raux-en-Y groups. The nutritional status of these two groups was investigated. Results The differences of body weight, hemoglobin and total albumin before and after operation in P loop group were (5. 65 ± 2. 3) kg, (2.14 ± 1.6) g/L and (0.95±0.7) g/L; Meanwhile those in Kuroyangai group were(4. 29 ± 1.6) kg, (1.10 ± 0. 8) g/ L and (0. 96 ± 0. 9) g/L respectively. These differences between two groups were not significant( P> 0. 05) . Conclusion Kuroyangai/Rouz-en-Y reconstructive alimentary canal for total gastrectomy is a better surgical method.