全胃切除术后三种消化道重建术式治疗胃癌的对比研究

Comparative study on three methods of digestive tract reconstruction after total gastrectomy due to gastric cancer

目的对比分析全胃切除术后三种消化道重建术式治疗胃癌的手术效果。方法全部入选的90例胃癌患者根据消化道重建方式不同随机分为A、B、C三组,每组30例,比较三组患者的手术时间、术中出血量、住院时间。三组体重下降情况及每日进餐次数、术后并发症发生率。结果B组手术时间最长,C组出血量最多,B组住院时间最长。A组、C组手术时间及住院时间分别显著短于B组,差异有显著性(P<0.05)。A组、B组术中出血量分别显著少于B组,差异有显著性(P<0.05)。C组患者体重下降数值最少,C组每日进餐次数最多,与A组、B组分别比较,差异有显著性(P<0.05)。三组患者术后并发症发生率分别为20.0%、23.3%、10.0%,C组的并发症发生率显著低于其他各组,组间比较差异有显著性(P<0.05)。结论全胃切除术后行改良功能性空肠间置代胃术虽然手术时间长、术中出血多,但术后患者恢复快、营养状况好,并发症最少,值得推广和应用。

Objective To compare the outcome of three methods of digestive tract reconstruction after total gastrectomy due to gastric cancer. Methods A total of 90 patients after total gastrectomy due to gastric cancer were selected and divided into three groups according to the method of digestive tract reconstruction, with 30 patients in each group. The following aspects were compared:The operation time, blood loss, and hospital stay;and the weight loss, number of diets, and incidence of complications. Results The operation time was the longest in group B, the blood loss was the most in group C, and the hospital stay was the longest in group B. The operation time and hospital stay in group A and goup C were significantly shorted than those in group B(P<0.05). The blood loss in group A and group B was significantly lower than that in group C(P<0.05). The body weight decreased least in group C and the number of diets was most in group C, and the differences with those of group A and goup B were significant(P<0.05). The incidence rates of complications were 20.0%, 23.3%, and 10.0% in the three groups, which was significantly lower in group C(P<0.05). Conclusion Despite of longer operation time and more blood loss, patients after modified functional jejunal interposition after total gastrectomy recover rapidly with good nutrition condition and fewest complications, thus it is worthy to be promoted.