不同消化道重建方案治疗早期贲门癌患者的疗效观察

Effect observation of different digestive tract reconstruction plans on treatment of patients with early carcinoma of gastric cardia

目的比较不同消化道重建方案治疗早期贲门癌患者的疗效。方法选取120例早期贲门癌患者并随机分为3组。A组实施食管残胃前壁吻合联合幽门成型的消化道重建方案,B组实施食管残胃后壁吻合联合唇式包埋的消化道重建方案,C组实施食管残胃3S空肠间置吻合的消化道重建方案。比较3组患者的手术情况、治疗前后的营养指标以及治疗前后的EORTC QLQ-C30评分情况。结果 3组患者的手术时间、术中出血量以及术后住院时间等无显著差异(P<0.05);3组患者治疗后的血红蛋白、总蛋白、白蛋白、维生素B_(12)、体质量等指标显著改善(P<0.05),且3组间比较有显著差异(P<0.05)。3组患者治疗后的EORTC QLQ-C30评分均显著优于治疗前(P<0.05),且3组间比较有显著差异(P<0.05)。结论对于早期贲门癌患者,实施食管残胃前壁吻合联合幽门成型的消化道重建方案的疗效好。

Objective To compare the effects of different digestive tract reconstruction plans on the treatment of patients with early carcinoma of gastric cardia. Methods A total of 120 patients with early carcinoma of gastric cardia were selected and divided into three groups. Patients in group A were treated with residual stomach esophagus wall anastomosis combined with pyloric forming scheme,patients in group B were treated with esophageal gastric remnant after wall anastomosis combined lip type embedded scheme,and patients in group C were treated with esophageal gastric remnant 3S jejunum home anastomosis scheme. The operation condition,the nutritive index and the QLQ-C30 EORTC score before and after treatment were compared among the three groups. Results There were no significant differences in operation time,the amount of bleeding and hospital stay among three groups（ P〈0. 05）. After treatment,the hemoglobin,total protein,albumin,vitamin B12,weight and other indicators in all patients were significantly better than those before treatment（ P〈0. 05）,and there were significant differences among three groups（ P〈0. 05）. After treatment,the EORTC QLQ-C30 scores of all patients were significantly better than those before treatment（ P〈0. 05）,and there were significant differences among three groups（ P〈0. 05）. Conclusion For the patients with early carcinoma of gastric cardia,the implementation of residual stomach esophagus wall anastomosis combined with pyloric forming scheme is good.