两种消化道重建术式对胃癌影响的临床探讨

Two kinds of Digestive Tract Reconstruction Surgery Clinical Observation of the Impact of Gastric Cancer

目的对比分析全胃切除术后功能性间置空肠代胃术与Roux-en-Y术两种消化道重建方式的术后患者疗效。方法随机选择该院于2011年2月—2013年2月医治的70例因胃癌进行了全胃切除手术的患者作为研究对象,分为观察组和对照组各35例。观察组利用食管空肠吻合以及空肠侧侧吻合术为患者进行消化道重建,对照组则采用P形空肠袢空肠食管Roux-en-Y吻合术手术对消化道进行重建。观察并记录两组患者1年后的血红蛋白、白蛋白、总蛋白、体质量、并发症以及每天的进食次数数据情况变化。结果一年之后,观察组与对照组患者的白蛋白、血红蛋白、总蛋白值均接近正常指数,两组数据之间比较差异无统计学意义(P>0.05);而两组患者的进食次数和体质量对比上,观察组明显优于对照组。两组相比较差异具有统计学意义(P<0.05)。两组患者的术后并发症,对照组早饱症比例为14.3%,倾倒综合征占11.4%,反流性食道炎为8.5%;观察组的指数分别为5.7%、2.8%、2.8%,相比较而言观察组并发症例数明显少于对照组,两组相比较差异具有统计学意义(P<0.05)。结论综上所述,两种手术方式相比较,食管空肠吻合以及空肠侧侧吻合术对于胃癌需重建消化道患者,不仅能够促使血蛋白各项指标迅速恢复正常,增加进食次数与体质量,而且术后患者并发症较少,及时有效的治愈患者消化道疾病,临床可对其讲行推广应用。

Objective To comparison and analysis between functional after total gastrectomy jejunum generation stomach insertion. we and Roux en-Y two types of the digestive tract reconstruction of the postoperative patients with curative effect. Methods se-lecting 70 patients from 2011 February to 2013 February in our hospital with gastric cancer in our hospital to heal for a full stom-ach surgery patients as the research object, is divided into observation group and control group （n=35）.Observation group with esophagus jejunum anastomosis and jejunum anastomosis of lateral side for patients with digestive tract reconstruction, control group adopts P form loops of jejunum jejunum anastomosis of esophageal Roux en - Y surgery on the digestive tract reconstruc-tion. Observe and record two groups of patients after 1 years of hemoglobin, albumin, total protein,body weight,complications and every day.Results A year later, groups of patients with serum albumin, hemoglobin, total protein in the observation group and the control values were close to the normal index, no significant difference between the two groups of data （P〈0.05）, the difference was not statistically significant; while the two groups of patients with eating frequency and weight comparison, the observation group was significantly better than the control group. The comparison of the two groups is significantly different, with statistical significance （P〈0.05）. Two groups of patients with postoperative complications, early satiety in the control group was 14.3%, dumping syndrome accounted for 11.4%, reflux esophagitis was 8.5%;the observation group index were 5.7%, 2.8%, 2.8%, compared in terms of com-plications in the observation group were significantly less than the control group, compared the two groups differed significantly, with statistical significance （P〈0.05）. Conclusion To sum up, two kinds of operation modes are compared, and the jejunum anas-tomosis for reconstruction of side to side anastomosis of gastric cancer in patients with digestive tract, not only can promote the blood protein targets quickly returned to normal, to increase the frequency of eating and body weight, and the postoperative patients with fewer complications, timely and effective cure for patients with digestive tract disease, clinical application.