三角吻合术在食管胃颈部消化道重建中的疗效分析

Curative Effect Analysis of Triangle Anastomosis in Alimentary Reconstruction of Esophagogastric Cervical

为了探讨三角吻合术在食管胃颈部消化道重建中的安全性和可行性临床疗效。选择我院2010年1月至2014年11月需要行微创食管切除、食管胃颈部吻合术手术的患者100例,按照随机数字表法分为观察组和对照组各50例,考察两组患者围手术期情况、术后并发症、术后随访情况和SF-36量表生活质量情况。结果显示,围手术期中观察组出血量显著少于对照组,手术时间显著长于对照组,其他项目所用时长观察组均显著短于对照组;观察组出现吻合口瘘、吻合口狭窄、腹腔感染、肠梗阻、术后并发症的患者数量均低于对照组;观察组出现身体不适的患者数量少于对照组;观察组各维度除情绪角色和心理健康两维度以外,其他维度得分均显著高于对照组。研究表明,三角吻合术在微创食管切除、食管胃颈部吻合术围手术期情况优于传统吻合术,且术后并发症减少,术后患者随访情况和生活质量均好于传统吻合术。

In order to investigate the safety and feasibility of clinical efficacy of the triangle anastomosis in alimentary reconstruction of esophagogastric cervical,100 cases of patients who were treated with minimally invasive esophagectomy and neck esophageal anastomosis surgery in our hospital from January 2013 to November 2014 were selected.According to the method of random number table,the patients were divided into observation group and control group with 50 cases in each group.The perioperative conditions,postoperative complications,follow-up and SF-36 quality of life of the two groups were investigated.The results showed that the haemorrhagia amount in the observation group during the perioperative period was significantly less than that in the control group,the operation time of observation group was significantly longer than that of the control group,and the time of observation group used in other items was significantly shorter than the control group.The number of patients in the observation group with anastomotic fistula,anastomotic stenosis,abdominal infection,intestinal obstruction and postoperative complication was less than that in the control group.The number o f patients with physical discomfort in the observation group was less than that in the control group.Except for the emotional role and mental health,the scores of other dimensions of the observation group were significantly higher than those of the control group.This study suggested that the perioperative conditions of triangle anastomosis was better than the traditional anastomosis in the minimally invasive esophagectomy and neck esophageal anastomosis surgery.Inadditon,the postoperative complications,postoperative follow-up and quality of life of patients treated by triangle anastomosis were better than those of patients treated by conventional anastomosis.