全胃切除空肠代胃Lahey术式和Nadrowski推荐术式的临床疗效比较

Clinical Curafive Effect Compare of Operation Fashion of Lahey and Nadrowski,which Substitute Jejunum for Gastric after Pan-gastrectomy

目的 观察、总结和分析全胃切除后 Lahey术式与 Nadrowsdi推荐术式的临床疗效。 方法 选择经医师直接随访复查 6个月至 1年的全胃切除后饮食量、体力恢复、后遗症及并发症等项目 ,然后评定疗效。 结果 Lahey术式 3 4例中 ,吻合口瘘 2例 ,肺部感染 3例 ,吻合口狭窄 4例 ,腹壁裂开、腹腔感染 3例 ,并发症发生率 3 5.3 % ;Nadrowski推荐术式 1 8例中仅吻合口瘘 1例 ,经 1周治疗痊愈出院 ,并发症发生率为 5.5% ,两者差异显著 (P <0 .0 5)。 Lahey术式正常饮食量 2 2例 ,体力恢复 1 9例 ,反流性食管炎 2 4例 ,营养不良 1 8例 ,腹泻 7例 ;Nadrowski推荐术式正常饮食量 1 6例 ,体力恢复 1 5例 ,营养不良 1例 ,无反流性食管炎和腹泻病例 ,两者除体力恢复无显著差异外 ,其余各项均有显著性差异 (P <0 .0 5～ 0 .0 1 )。 结论 Nadrowski推荐术式优于 Lahey术式。

Objective Clinical curative effect of after pan-gastrectomy operation fashion of Lahey and Nadrowski recowmendatory were observed,summarzed and analyzed Methods Therapeutic effect were assessed to the diet,brawn Recovery,Requela and complications ebc of after pan-gastrectomy by doctors for direct afterwards call-on and callback of time with 6 month to 1 year Results Rhynchostome fistula for 2 cases,peeumonia for 3 cases,rhyncho-stome narrowness for 4 cases,dehiscence of abdominal incisions,and abdominal infecfion for 3 cases,in the Lahey operaton for 34 cases complication ccurred rate in this series is 35 3% in the Nadrowski Recowmendatory opertion for 18 cases rhnchostome fistula only for 1 case,complication ccurred rate in this serie is 5 5%,the statistical figures(P<0 05) Show the significant differences former was normal diet for 22 cases,brawn recovery for 19 cases,esophagitis of reflux for 24 cases,innutrition for 18 cases,diarrthea for 7 cases Later one was separately 16、15、0、1、0 Brawn recovery of the both showed no obvinos abnormal,the other item showed significant differences(P<0 05~0 01)  Conclusion Operation fashion of Nadrowski and Lahey,the former was bettfer Nadrowski operational fashion is an best nutritive perspectiue and operational simple operation,which substituted jejunum for gastric in the turn of the century [