胃窦浆肌瓣转移幽门成形术对近端胃切除患者术后应用的效果

Postoperative application effect of gastric antrum plasma muscle flap transfer pyloroplasty for patients with proximal gastrectomy

目的研究胃窦浆肌瓣转移幽门成形术对近端胃切除患者术后应用的效果。方法随机选取2013年1月至2021年4月莆田市第一医院收治的需进行近端胃切除胃部疾病患者92例,通过信封法随机分为对照组(n=46,采用临床常规的手术方式,不附加胃窦浆肌瓣转移幽门成形术)和试验组(n=46,近端胃切除术后附加胃窦浆肌瓣转移幽门成形术),在干预3个月后比较并分析两组患者术后恢复情况、胃排空障碍发生情况、反流性食管炎发生情况以及患者对治疗的满意度。结果试验组胃管留置时间、胃管引流量、肠道功能恢复时间及住院时间明显少于对照组(P<0.05);试验组胃排空障碍发生率为6.52%(3/46),明显低于对照组的32.61%(15/46),差异有统计学意义(P<0.05);手术治疗3个月后试验组反流性食管炎总发生率为23.91%(11/46),显著低于对照组的60.87%(28/46),差异有统计学意义(P<0.05);试验组治疗总满意度为89.13%(41/46),显著高于对照组的54.35%(25/46),差异有统计学意义(P<0.05)。结论胃窦浆肌瓣转移幽门成形术对近端胃切除患者具有良好的应用效果,可以预防胃排空障碍,显著减少反流性食管炎的发生,提高患者对治疗的满意度,在近端胃切除患者临床治疗上具有重要的意义。

Objective To study the postoperative application effect of gastric antrum plasma muscle flap transfer pyloroplasty for patients with proximal gastrectomy.Methods From January 2013 to April 2021,92 patients with gastric disease who needed proximal gastrectomy were randomly selected from Putian First Hospital,and randomly divided into control group(n=46,using clinical conventional surgical methods,without additional sinus plasma muscle flap transfer pylorinoplasty)and experimental group(n=46,additional gastric sinus plasma muscle flap transfer pylorinoplasty after proximal gastrectomy)by envelope method.3 months after the intervention,the postoperative recovery,the occurrence of gastric emptying disorder,reflux esophagitis and patients’satisfaction with treatment were compared and analyzed between the two groups.Results Compared with the control group,the gastric tube indwelling time,gastric tube drainage,intestinal function recovery time and hospitalization time in the experimental group were significantly less than those in the control group(P<0.05);The incidence of gastric emptying disorder in the experimental group was 6.52%(3/46)significantly lower than that in the control group of 32.61%(15/46),and the difference was statistically significant(P<0.05);The overall incidence of reflux esophagitis in the experimental group after three months of surgical treatment was 23.91%(11/46),significantly lower than that in the control group of 60.87%(28/46),and the difference was statistically significant(P<0.05);The total satisfaction of treatment in the experimental group was 89.13%(41/46),which was significantly higher than that in the control group 54.35%(25/46),and the difference was statistically significant(P<0.05).Conclusion Gastric antrum plasma muscle flap transfer pyloroplasty has good application effects on patients with proximal gastrectomy.It can prevent gastric emptying disorder,significantly reduce the occurrence of reflux esophagitis,and improve patients’satisfaction with treatment,which is of important significance in the clinical treatment of patients with proximal gastrectomy.