管状胃代食管术在食管癌切除术中的安全性及临床疗效研究

The safety and clinical efficacy research of tubular esophagogastrostomy in esophageal carcinoma

目的探讨食管癌切除术中采取管状胃代食管术的疗效与安全性。方法选择我院2013年4月—2016年4月接诊的食管癌切除术患者60例作为研究对象,随机分为研究组和对照组30例。对照组患者采取全胃代食管术治疗,研究组采取管状胃代食管术治疗,观察记录2组手术时间、术中出血量、胃肠减压时间、并发症发生情况,以及术前术后生活质量量表GQOL-74评分。结果 2组患者手术时间比较差异无统计学意义(P>0.05);研究组术中出血量与胃肠减压时间均明显低于对照组(P<0.05);2组均有并发症发生,其中研究组胸胃综合征、反流性食管炎发生率明显低于对照组(P<0.05),但2组吻合口狭窄、胸腔感染、切口感染、吻合口瘘、胃排空障碍等发生率比较无明显差异(P>0.05);2组患者术前GQOL-74评分比较无明显差异(P>0.05),术后研究组心理功能、躯体功能、物质生活、社会功能及总评分均明显高于对照组(P<0.05)。结论管状胃代食管术在食管癌切除术中不仅疗效好,安全性佳,而且术中出血量少,术后生活质量更好,值得推广。

Objective To explore the Safety and clinical efficacy research of tubular esophagogastrostomy in esophageal carcinoma. Methods 60 cases patients with esophageal carcinoma were involved this study from April 2013-April 2016.Into the research object with complete clinical data,signed informed consent,randomized group,30 cases in each group.Control group patients to take the whole generation for the treatment of esophagus, stomach team are taking a tubular generation for the treatment of esophageal,stomach observed two groups of patients with gastrointestinal decompression operation time, intraoperative blood loss,time,complications,and preoperative postoperative quality of life scale GQOL-74 score,and comparative analysis. Results The patients with operation time is similar between the two groups had no statistical significance （ P〉0.05 ） ; Bleeding amount of team and gastrointestinal decompression time were significantly lower than control group （P〈0.05） ; Two groups all have complications, including team, reflux esophagitis incidence of thoracic stomach syndrome were significantly lower than control group （P〈0.05）, but the two groups of anastomotic stricture, chest infection, infection of incision, anastomotic fistula,the incidence of gastric emptying disorder was no significant difference （P〉0.05） ;Two groups of patients with preoperative GQOL-74 score was no significant difference （P〉0.05）, postoperative psychological function, physical function, material life, social function and total score were significantly higher than that of control group （P〈O.05）.Conclusion Tubular esophagus stomach generation in esophageal cancer resection operation not only curative effect is better,safer,and less intraoperative blood loss, postoperative quality of life better, is worth using for reference.