胃癌全胃切除术后两种消化道重建术式的对比研究

The comparative study of the two kinds of digestive tract reconstruction after total gastrectomy for gastric cancer

目的探讨胃癌全胃切除术后功能性空肠间置代胃重建术和P型Roux-en-Y全胃切除空肠代胃术两种消化道重建方式对于患者术后生活质量、营养状态的影响。方法 2012年1月至2014年1月实施全胃切除的80例胃癌患者中,40例行功能性空肠间置代胃重建术,40例行P型Roux-en-Y空肠代胃术。随访2年,对其术后并发症、VISICK指数、体重变化及营养指标进行对比观察。结果功能性间置空肠代胃术后患者的VISICK指数为Ⅰ-Ⅱ级,患者体重变化,营养指标等明显优于P型Roux-en-Y全胃切除空肠代胃术,能有效防止反流性食管炎、倾倒综合征等。结论功能性间置空肠代胃术对于减少全胃切除术后的并发症,提高患者术后的生活质量有极大意义,是较为理想的术式,值得临床推广应用。

Objective To investigate the quality of life and nutritional status with the two kinds of digestive track reconstruction, the functional jejunum interposition reconstruction（gastric reconstruction by functional jejunalinterposition, FJI） and P-type Roux-en-Y reconstruction（Pmodel-Roux-en-Y, PR） after total gastrectomy for gastric cancer. Methods From 2012 to 2014, eighty patients with gastric cancer were performed total gastric resection, 40 ceases are FJIR, the others are PRR. Two years of following up, the postoperative complications, VISICK index, weight and nutritional indexes were observed. Results VISICK index of FJIR patients is Ⅰ-Ⅱ stage, and weight, nutritional indexes obviously are better than that of PR. FJIR can effectively prevent the reflux esophagitis, and dumping syndrome, etc. Conclusion FJIR can reduce the postoperative complications, improve the quality of life in patients with total gastrectomy, and be worthy of clinical popularization and application.