食管空肠π形Roux-en-Y吻合术联合奥沙利铂+替吉奥化疗方案对胃癌患者的疗效观察

Effect of π-shaped Roux-en-Y anastomosis of esophagus and jejunum combined with oxaliplatin+tigio chemotherapy on nutritional function and digestive tract reconstruction in patients with gastric cancer

目的探讨食管空肠π形Roux-en-Y吻合术联合奥沙利铂+替吉奥化疗方案对胃癌患者的临床治疗效果。方法选取2017年6月至2018年6在延安大学附属医院行胃癌根治+食管空肠π形Roux-en-Y吻合术的患者120例,根据术后应用化疗方案的不同分为观察组和对照组。其中观察组62例,术后接受奥沙利铂+替吉奥方案化疗;对照组58例,术后接受FOLFOX6方案化疗。观察两组患者的消化道重建情况(首次肛门排气时间、首次排便时间)、营养指标恢复情况及近期疗效。结果两组患者均出现了不同程度的进食后胃疼、反酸、烧心等不适。观察组的术后发热时间、首次肛门排气时间、首次排便时间与对照组比较差异均无显著性(P>0.05)。术前两组总蛋白、白蛋白、血红蛋白及体重等各项营养指标比较差异无显著性(P>0.05)。术后6个月两组各项营养指标均明显高于术前,且观察组明显高于对照组,差异均有显著性(P<0.05)。观察组的客观有效率为64.52%(40/62),明显高于对照组的34.48%(20/58),差异有显著性(χ^(2)=10.812,P<0.05)。结论食管空肠π形Roux-en-Y吻合术联合奥沙利铂+替吉奥化疗对胃癌根治术后消化道重建无明显不良影响,且可促进患者营养功能恢复,提高近期疗效。

Objective To investigate the clinical treatment effect of esophageal jejunum π-shaped Roux-en-Y anastomosis combined with oxaliplatin+tigio chemotherapy on patients with gastric cancer.Method A total of 120 patients who underwent radical gastric cancer+Roux-en-Y anastomosis of esophagojejunum in the Affiliated Hospital of Yan’an University from June 2017 to June 2018 were selected and divided into observation group and control group according to different postoperative chemotherapy regimens.Among them,62 cases in the observation group received oxaliplatin+ticgio regimen chemotherapy after operation;58 cases in the control group received FOLFOX6 chemotherapy regimen after opera tion.Observe the reconstruction of the digestive tract(the tim e of first anal exhaust,the time of first defecation),the recovery of nutritional indicators and the short-term efficacy of the two groups of patients.Result Both groups of patients experienced different degrees of discomfort such as stomach pain,acid reflux,and heartburn after eating.There was no significant difference in the postoperative fever time,the first anal exhaust time,and the first defecation time between the observation group and the control group(P>0.05).There was no significant difference in nutritional indicators such as total protein,albumin,hemoglobin and body weight between the two groups before operation(P>0.05).At 6 months after operation,the nutritional indicators of the two groups were significantly higher than those before the operation,and the observation group was significantly higher than the control group,the difference was significant(P<0.05).The objective effective rate of the observation group was 64.52%(40/62),which was significantly higher than 34.48%(20/58)of the control group.The difference was significant(χ^(2)=10.812,P<0.05).Conclusion Esophageal-jejunal π-shaped Roux-en-Y anastomosis combined with oxaliplatin+tigio chemotherapy has no significant adverse effects on gastrointestinal reconstruction after radical resection of gastric cancer,and can promote the recovery of patients’nutritional function and improve the short-term efficacy.