A crude polysaccharide was extracted from Physalis alkekengi L. fruit. HPLC was used for the component analysis of the polysaccharide. The results indicate that Physalis alkekengi L. polysaccharide（PAP） was composed...A crude polysaccharide was extracted from Physalis alkekengi L. fruit. HPLC was used for the component analysis of the polysaccharide. The results indicate that Physalis alkekengi L. polysaccharide（PAP） was composed of rhamnose, xylose, arabinose, galactose, and glucose. Free radicals scavenging activity of PAP was studied through 3 free radicals scavenging tests. PAP exhibited high scavenging effects on OH and DPPH radicals, and both the scavenging rates were about 80%. The scavenging rate of O2^- radical was about 22%.展开更多
AIM: To assess the 6-mo and 12-mo functional outcomes after retropubic, laparoscopic and robot-assisted laparoscopic radical prostatectomy retropubic radical prostatectomy(RRP) laparoscopic radical prostatectomy(LRP);...AIM: To assess the 6-mo and 12-mo functional outcomes after retropubic, laparoscopic and robot-assisted laparoscopic radical prostatectomy retropubic radical prostatectomy(RRP) laparoscopic radical prostatectomy(LRP); robot-assisted laparoscopic prostatectomy(RARP). METHODS: A literature search was conducted using the Pub Med, EMBASE, The Cochrane Library and the Web of Knowledge databases updated to March, 2014 for relevant published studies. After data extraction and quality assessment via the Newcastle-Ottawa Scale or the Cochrane collaboration's tool for assessing risk ofbias, meta-analysis was performed using Rev Man 5.1. Either a random-effects model or a fixed-effects model was used. Potential publication bias was assessed using visual inspection of the funnel plots, and verified by the Egger linear regression test. RESULTS: Thirty-seven studies were identified in total: 14 articles comparing LRP with RRP, 12 articles comparing RARP with RRP, and 11 articles comparing RARP with LRP. For urinary continence, a statistically significant advantage was observed in RARP compared with LRP or RRP both at 6 mo [odds ratio(OR) = 1.93; P < 0.01, OR = 2.23; P < 0.05, respectively] and 12 mo(OR = 1.47; P < 0.01, OR = 2.93; P < 0.01, respectively) postoperatively. The continence recovery rates after LRP and RRP, with obvious heterogeneity(6-mo: I2 = 74%; 12-mo: I2 = 75%), were equivalent(6-mo: P = 0.52; 12-mo: P = 0.75). In terms of potency recovery, for the first time, we ranked the three surgical approaches into a superiority level: RARP > LRP > RRP, with a statistically significant difference at 12 mo [RARP vs LRP(OR = 1.99; P < 0.01); RARP vs RRP(OR = 2.66; P < 0.01); LRP vs RRP(OR = 1.34; P < 0.05)], respectively. Meta-regression and subgroup analyses according to adjustment of the age, body mass index, prostate volume, Gleason score or prostate-specific antigen did not vary significantly. CONCLUSION: Current evidence suggests that minimally invasive approaches(RARP or LRP) are effective procedures for functional recovery. However, more high-quality randomized control trials investigating the long-term functional outcomes are needed.展开更多
BACKGROUND Laparoscopic-assisted radical gastrectomy(LARG)is the standard treatment for early-stage gastric carcinoma(GC).However,the negative impact of this proce-dure on respiratory function requires the optimized i...BACKGROUND Laparoscopic-assisted radical gastrectomy(LARG)is the standard treatment for early-stage gastric carcinoma(GC).However,the negative impact of this proce-dure on respiratory function requires the optimized intraoperative management of patients in terms of ventilation.AIM To investigate the influence of pressure-controlled ventilation volume-guaranteed(PCV-VG)and volume-controlled ventilation(VCV)on blood gas analysis and pulmonary ventilation in patients undergoing LARG for GC based on the lung ultrasound score(LUS).METHODS The study included 103 patients with GC undergoing LARG from May 2020 to May 2023,with 52 cases undergoing PCV-VG(research group)and 51 cases undergoing VCV(control group).LUS were recorded at the time of entering the operating room(T0),20 minutes after anesthesia with endotracheal intubation(T1),30 minutes after artificial pneumoperitoneum(PP)establishment(T2),and 15 minutes after endotracheal tube removal(T5).For blood gas analysis,arterial partial pressure of oxygen(PaO_(2))and partial pressure of carbon dioxide(PaCO_(2))were observed.Peak airway pressure(P_(peak)),plateau pressure(Pplat),mean airway pressure(P_(mean)),and dynamic pulmonary compliance(C_(dyn))were recorded at T1 and T2,1 hour after PP establishment(T3),and at the end of the operation(T4).Postoperative pulmonary complications(PPCs)were recorded.Pre-and postoperative serum interleukin(IL)-1β,IL-6,and tumor necrosis factor-α(TNF-α)were measured by enzyme-linked immunosorbent assay.RESULTS Compared with those at T0,the whole,anterior,lateral,posterior,upper,lower,left,and right lung LUS of the research group were significantly reduced at T1,T2,and T5;in the control group,the LUS of the whole and partial lung regions(posterior,lower,and right lung)decreased significantly at T2,while at T5,the LUS of the whole and some regions(lateral,lower,and left lung)increased significantly.In comparison with the control group,the whole and regional LUS of the research group were reduced at T1,T2,and T5,with an increase in PaO_(2),decrease in PaCO_(2),reduction in P_(peak) at T1 to T4,increase in P_(mean) and C_(dyn),and decrease in Pplat at T4,all significant.The research group showed a significantly lower incidence of PPCs than the control group within 3 days postoperatively.Postoperative IL-1β,IL-6,and TNF-αsignificantly increased in both groups,with even higher levels in the control group.CONCLUSION LUS can indicate intraoperative non-uniformity and postural changes in pulmonary ventilation under PCV-VG and VCV.Under the lung protective ventilation strategy,the PCV-VG mode more significantly improved intraop-erative lung ventilation in patients undergoing LARG for GC and reduced lung injury-related cytokine production,thereby alleviating lung injury.展开更多
BACKGROUND Gallbladder cancer(GBC)is the most common malignant tumor of the biliary system,and is often undetected until advanced stages,making curative surgery unfeasible for many patients.Curative surgery remains th...BACKGROUND Gallbladder cancer(GBC)is the most common malignant tumor of the biliary system,and is often undetected until advanced stages,making curative surgery unfeasible for many patients.Curative surgery remains the only option for long-term survival.Accurate postsurgical prognosis is crucial for effective treatment planning.tumor-node-metastasis staging,which focuses on tumor infiltration,lymph node metastasis,and distant metastasis,limits the accuracy of prognosis.Nomograms offer a more comprehensive and personalized approach by visually analyzing a broader range of prognostic factors,enhancing the precision of treatment planning for patients with GBC.AIM A retrospective study analyzed the clinical and pathological data of 93 patients who underwent radical surgery for GBC at Peking University People's Hospital from January 2015 to December 2020.Kaplan-Meier analysis was used to calculate the 1-,2-and 3-year survival rates.The log-rank test was used to evaluate factors impacting prognosis,with survival curves plotted for significant variables.Single-factor analysis revealed statistically significant differences,and multivariate Cox regression identified independent prognostic factors.A nomogram was developed and validated with receiver operating characteristic curves and calibration curves.Among 93 patients who underwent radical surgery for GBC,30 patients survived,accounting for 32.26%of the sample,with a median survival time of 38 months.The 1-year,2-year,and 3-year survival rates were 83.87%,68.82%,and 53.57%,respectively.Univariate analysis revealed that carbohydrate antigen 19-9 expre-ssion,T stage,lymph node metastasis,histological differentiation,surgical margins,and invasion of the liver,ex-trahepatic bile duct,nerves,and vessels(P≤0.001)significantly impacted patient prognosis after curative surgery.Multivariate Cox regression identified lymph node metastasis(P=0.03),histological differentiation(P<0.05),nerve invasion(P=0.036),and extrahepatic bile duct invasion(P=0.014)as independent risk factors.A nomogram model with a concordance index of 0.838 was developed.Internal validation confirmed the model's consistency in predicting the 1-year,2-year,and 3-year survival rates.CONCLUSION Lymph node metastasis,tumor differentiation,extrahepatic bile duct invasion,and perineural invasion are independent risk factors.A nomogram based on these factors can be used to personalize and improve treatment strategies.展开更多
Ar/C_2H_5OH plasma jet is generated at atmospheric pressure by 33 MHz radio-frequency power source. This RF excitation frequencies which are higher than 13.56 MHz had rarely been used in atmospheric pressure plasma. T...Ar/C_2H_5OH plasma jet is generated at atmospheric pressure by 33 MHz radio-frequency power source. This RF excitation frequencies which are higher than 13.56 MHz had rarely been used in atmospheric pressure plasma. The plasma characteristics of ethanol are investigated. The introduction of ethanol leads to the generation of four excited carbonaceous species C, CN, CH and C_2 in plasma, respectively. Optical emission intensities of four carbonaceous species were strengthened with ethanol content increasing in the range of 0-4600 ppm. The ethanol content increase results in all the Ar spectra lines decrease. The reason is that the electron temperature decreases when ethanol content is high. The emission intensity ratios of C/C_2, CN/C_2 and CH/C_2 decrease with the increase of ethanol content, showing that the relative amount of C_2 is increasing by increasing the ethanol flow. The emission intensity ratios of excited species did not change much with the increase of RF power in stable discharge mode.展开更多
Plasma initiated polymerization is a kind of well-known radical polymerization mechanism, but it has the ＇living＇ polymerization feature and produces ultra-high molecular weight polymer. In order to explain such phe...Plasma initiated polymerization is a kind of well-known radical polymerization mechanism, but it has the ＇living＇ polymerization feature and produces ultra-high molecular weight polymer. In order to explain such phenomena, we calculate the basic data of plasma initiated polymerization of methylmethacrylate （MMA） according to the principle of polymer physics and chemistry. It results in that the radical concentration ranges from 10^-12mol/L to 10^-16mol/L corresponding to the radical life in 10^4s to 10^8s, which means the radicals have a long lifetime. Moreover because of the long lifetime radicals it causes a unique feature rather than the common radical polymerization, and also shows no ＂living polymerization＂. It is noticed in experiments that there are two key factors playing important roles. One is the effective radical amount produced during the plasma discharging while the another is the diffusion factor.展开更多
目的调查宫颈癌患者术后发生盆底功能障碍性疾病(pelvic fl oor dysfunction,PFD)现状,分析影响因素并提出预防措施。方法选取2023年1—7月在长沙市某三级甲等医院住院的宫颈癌根治术后患者178例为调查对象,使用自行设计的问卷对患者进...目的调查宫颈癌患者术后发生盆底功能障碍性疾病(pelvic fl oor dysfunction,PFD)现状,分析影响因素并提出预防措施。方法选取2023年1—7月在长沙市某三级甲等医院住院的宫颈癌根治术后患者178例为调查对象,使用自行设计的问卷对患者进行横调查,并使用Logistic回归分析宫颈癌根治术后患者盆底功能障碍性疾病的影响因素。结果178例宫颈癌根治术后患者中,105例患者(58.99%)存在盆底功能障碍性疾病,单因素分析结果显示,年龄、妊娠次数、分娩方式、肿瘤直径、绝经、便秘、留置导尿管时间、阴道切除长度均是影响宫颈癌根治术后患者发生盆底功能障碍性疾病的因素(P<0.05),多因素Logistic回归分析结果显示,绝经、便秘、妊娠次数、分娩方式、留置导尿管时间、阴道切除长度为宫颈癌根治术后患者发生盆底功能障碍性疾病的影响因素(P<0.05)。结论宫颈癌根治术后患者女性盆底功能障碍(female pelvic fl oor dysfunction,FPFD)发生率高,绝经、便秘、妊娠次数≥3,阴道分娩、留置导尿管时间≥7 d、阴道切除长度≥3 cm是宫颈癌根治术后患者发生FPFD的危险因素,提示护理人员应给予此类患者更多关注,制定盆底康复训练计划,早期评估FPFD的发生,尽早采取有针对性的措施进行干预。展开更多
目的系统评价BillrothⅡ式与BillrothⅡ式联合Braun吻合重建术在腹腔镜远端胃癌根治术中的临床疗效差异。方法计算机检索CNKI、VIP、万方数据库、PubMed、Embase、Web of Science等,收集国内外公开发表关于两种消化道重建方式在腹腔镜...目的系统评价BillrothⅡ式与BillrothⅡ式联合Braun吻合重建术在腹腔镜远端胃癌根治术中的临床疗效差异。方法计算机检索CNKI、VIP、万方数据库、PubMed、Embase、Web of Science等,收集国内外公开发表关于两种消化道重建方式在腹腔镜远端胃癌根治术中比较的临床应用研究。检索时限为2000年1月至2022年10月。对纳入的临床研究进行质量评价及数量提取,并采用Cochrane协作网提供的RevMan5.3统计软件进行Meta分析。结果共纳入9项符合标准的研究,共1483例患者。Meta分析结果显示:在腹腔镜远端胃癌根治术中使用单纯BillrothⅡ式吻合手术时间及消化道重建时间短、术中出血量少,但使用BillrothⅡ联合Braun吻合住院时间短、近期总并发症少、远期反流性疾病少、远期营养状况好,差异均有统计学意义(P<0.05)。而淋巴结清扫数量、首次排气排便时间及部分短期并发症,差异无统计学意义(P>0.05)。结论腹腔镜远端胃癌根治术中,与单纯BillrothⅡ吻合相比,应用BillrothⅡ式联合Braun重建消化道,虽延长手术时间并增加术中出血量,但能减少患者术后近、远期并发症,减少术后住院时间,改善患者远期营养状况,临床应用具有一定优势。展开更多
基金Supported by the Science and Technique Foundation of Jilin Province, China(No20020503-2)
文摘A crude polysaccharide was extracted from Physalis alkekengi L. fruit. HPLC was used for the component analysis of the polysaccharide. The results indicate that Physalis alkekengi L. polysaccharide（PAP） was composed of rhamnose, xylose, arabinose, galactose, and glucose. Free radicals scavenging activity of PAP was studied through 3 free radicals scavenging tests. PAP exhibited high scavenging effects on OH and DPPH radicals, and both the scavenging rates were about 80%. The scavenging rate of O2^- radical was about 22%.
基金Supported by National Natural Science Foundation of China,No.81172734
文摘AIM: To assess the 6-mo and 12-mo functional outcomes after retropubic, laparoscopic and robot-assisted laparoscopic radical prostatectomy retropubic radical prostatectomy(RRP) laparoscopic radical prostatectomy(LRP); robot-assisted laparoscopic prostatectomy(RARP). METHODS: A literature search was conducted using the Pub Med, EMBASE, The Cochrane Library and the Web of Knowledge databases updated to March, 2014 for relevant published studies. After data extraction and quality assessment via the Newcastle-Ottawa Scale or the Cochrane collaboration's tool for assessing risk ofbias, meta-analysis was performed using Rev Man 5.1. Either a random-effects model or a fixed-effects model was used. Potential publication bias was assessed using visual inspection of the funnel plots, and verified by the Egger linear regression test. RESULTS: Thirty-seven studies were identified in total: 14 articles comparing LRP with RRP, 12 articles comparing RARP with RRP, and 11 articles comparing RARP with LRP. For urinary continence, a statistically significant advantage was observed in RARP compared with LRP or RRP both at 6 mo [odds ratio(OR) = 1.93; P < 0.01, OR = 2.23; P < 0.05, respectively] and 12 mo(OR = 1.47; P < 0.01, OR = 2.93; P < 0.01, respectively) postoperatively. The continence recovery rates after LRP and RRP, with obvious heterogeneity(6-mo: I2 = 74%; 12-mo: I2 = 75%), were equivalent(6-mo: P = 0.52; 12-mo: P = 0.75). In terms of potency recovery, for the first time, we ranked the three surgical approaches into a superiority level: RARP > LRP > RRP, with a statistically significant difference at 12 mo [RARP vs LRP(OR = 1.99; P < 0.01); RARP vs RRP(OR = 2.66; P < 0.01); LRP vs RRP(OR = 1.34; P < 0.05)], respectively. Meta-regression and subgroup analyses according to adjustment of the age, body mass index, prostate volume, Gleason score or prostate-specific antigen did not vary significantly. CONCLUSION: Current evidence suggests that minimally invasive approaches(RARP or LRP) are effective procedures for functional recovery. However, more high-quality randomized control trials investigating the long-term functional outcomes are needed.
文摘BACKGROUND Laparoscopic-assisted radical gastrectomy(LARG)is the standard treatment for early-stage gastric carcinoma(GC).However,the negative impact of this proce-dure on respiratory function requires the optimized intraoperative management of patients in terms of ventilation.AIM To investigate the influence of pressure-controlled ventilation volume-guaranteed(PCV-VG)and volume-controlled ventilation(VCV)on blood gas analysis and pulmonary ventilation in patients undergoing LARG for GC based on the lung ultrasound score(LUS).METHODS The study included 103 patients with GC undergoing LARG from May 2020 to May 2023,with 52 cases undergoing PCV-VG(research group)and 51 cases undergoing VCV(control group).LUS were recorded at the time of entering the operating room(T0),20 minutes after anesthesia with endotracheal intubation(T1),30 minutes after artificial pneumoperitoneum(PP)establishment(T2),and 15 minutes after endotracheal tube removal(T5).For blood gas analysis,arterial partial pressure of oxygen(PaO_(2))and partial pressure of carbon dioxide(PaCO_(2))were observed.Peak airway pressure(P_(peak)),plateau pressure(Pplat),mean airway pressure(P_(mean)),and dynamic pulmonary compliance(C_(dyn))were recorded at T1 and T2,1 hour after PP establishment(T3),and at the end of the operation(T4).Postoperative pulmonary complications(PPCs)were recorded.Pre-and postoperative serum interleukin(IL)-1β,IL-6,and tumor necrosis factor-α(TNF-α)were measured by enzyme-linked immunosorbent assay.RESULTS Compared with those at T0,the whole,anterior,lateral,posterior,upper,lower,left,and right lung LUS of the research group were significantly reduced at T1,T2,and T5;in the control group,the LUS of the whole and partial lung regions(posterior,lower,and right lung)decreased significantly at T2,while at T5,the LUS of the whole and some regions(lateral,lower,and left lung)increased significantly.In comparison with the control group,the whole and regional LUS of the research group were reduced at T1,T2,and T5,with an increase in PaO_(2),decrease in PaCO_(2),reduction in P_(peak) at T1 to T4,increase in P_(mean) and C_(dyn),and decrease in Pplat at T4,all significant.The research group showed a significantly lower incidence of PPCs than the control group within 3 days postoperatively.Postoperative IL-1β,IL-6,and TNF-αsignificantly increased in both groups,with even higher levels in the control group.CONCLUSION LUS can indicate intraoperative non-uniformity and postural changes in pulmonary ventilation under PCV-VG and VCV.Under the lung protective ventilation strategy,the PCV-VG mode more significantly improved intraop-erative lung ventilation in patients undergoing LARG for GC and reduced lung injury-related cytokine production,thereby alleviating lung injury.
基金Supported by Xiao-Ping Chen Foundation for The Development of Science and Technology of Hubei Province,No.CXPJJH122002-061.
文摘BACKGROUND Gallbladder cancer(GBC)is the most common malignant tumor of the biliary system,and is often undetected until advanced stages,making curative surgery unfeasible for many patients.Curative surgery remains the only option for long-term survival.Accurate postsurgical prognosis is crucial for effective treatment planning.tumor-node-metastasis staging,which focuses on tumor infiltration,lymph node metastasis,and distant metastasis,limits the accuracy of prognosis.Nomograms offer a more comprehensive and personalized approach by visually analyzing a broader range of prognostic factors,enhancing the precision of treatment planning for patients with GBC.AIM A retrospective study analyzed the clinical and pathological data of 93 patients who underwent radical surgery for GBC at Peking University People's Hospital from January 2015 to December 2020.Kaplan-Meier analysis was used to calculate the 1-,2-and 3-year survival rates.The log-rank test was used to evaluate factors impacting prognosis,with survival curves plotted for significant variables.Single-factor analysis revealed statistically significant differences,and multivariate Cox regression identified independent prognostic factors.A nomogram was developed and validated with receiver operating characteristic curves and calibration curves.Among 93 patients who underwent radical surgery for GBC,30 patients survived,accounting for 32.26%of the sample,with a median survival time of 38 months.The 1-year,2-year,and 3-year survival rates were 83.87%,68.82%,and 53.57%,respectively.Univariate analysis revealed that carbohydrate antigen 19-9 expre-ssion,T stage,lymph node metastasis,histological differentiation,surgical margins,and invasion of the liver,ex-trahepatic bile duct,nerves,and vessels(P≤0.001)significantly impacted patient prognosis after curative surgery.Multivariate Cox regression identified lymph node metastasis(P=0.03),histological differentiation(P<0.05),nerve invasion(P=0.036),and extrahepatic bile duct invasion(P=0.014)as independent risk factors.A nomogram model with a concordance index of 0.838 was developed.Internal validation confirmed the model's consistency in predicting the 1-year,2-year,and 3-year survival rates.CONCLUSION Lymph node metastasis,tumor differentiation,extrahepatic bile duct invasion,and perineural invasion are independent risk factors.A nomogram based on these factors can be used to personalize and improve treatment strategies.
基金support provided by National Natural Science Foundation of China (No. 11165012)Project of Natural Science Foundation of GanSu province (No. 145RJZA159)China Postdoctoral Science Foundation funded project (Nos. 2011M501494 and 2012T50831)
文摘Ar/C_2H_5OH plasma jet is generated at atmospheric pressure by 33 MHz radio-frequency power source. This RF excitation frequencies which are higher than 13.56 MHz had rarely been used in atmospheric pressure plasma. The plasma characteristics of ethanol are investigated. The introduction of ethanol leads to the generation of four excited carbonaceous species C, CN, CH and C_2 in plasma, respectively. Optical emission intensities of four carbonaceous species were strengthened with ethanol content increasing in the range of 0-4600 ppm. The ethanol content increase results in all the Ar spectra lines decrease. The reason is that the electron temperature decreases when ethanol content is high. The emission intensity ratios of C/C_2, CN/C_2 and CH/C_2 decrease with the increase of ethanol content, showing that the relative amount of C_2 is increasing by increasing the ethanol flow. The emission intensity ratios of excited species did not change much with the increase of RF power in stable discharge mode.
文摘Plasma initiated polymerization is a kind of well-known radical polymerization mechanism, but it has the ＇living＇ polymerization feature and produces ultra-high molecular weight polymer. In order to explain such phenomena, we calculate the basic data of plasma initiated polymerization of methylmethacrylate （MMA） according to the principle of polymer physics and chemistry. It results in that the radical concentration ranges from 10^-12mol/L to 10^-16mol/L corresponding to the radical life in 10^4s to 10^8s, which means the radicals have a long lifetime. Moreover because of the long lifetime radicals it causes a unique feature rather than the common radical polymerization, and also shows no ＂living polymerization＂. It is noticed in experiments that there are two key factors playing important roles. One is the effective radical amount produced during the plasma discharging while the another is the diffusion factor.
文摘目的调查宫颈癌患者术后发生盆底功能障碍性疾病(pelvic fl oor dysfunction,PFD)现状,分析影响因素并提出预防措施。方法选取2023年1—7月在长沙市某三级甲等医院住院的宫颈癌根治术后患者178例为调查对象,使用自行设计的问卷对患者进行横调查,并使用Logistic回归分析宫颈癌根治术后患者盆底功能障碍性疾病的影响因素。结果178例宫颈癌根治术后患者中,105例患者(58.99%)存在盆底功能障碍性疾病,单因素分析结果显示,年龄、妊娠次数、分娩方式、肿瘤直径、绝经、便秘、留置导尿管时间、阴道切除长度均是影响宫颈癌根治术后患者发生盆底功能障碍性疾病的因素(P<0.05),多因素Logistic回归分析结果显示,绝经、便秘、妊娠次数、分娩方式、留置导尿管时间、阴道切除长度为宫颈癌根治术后患者发生盆底功能障碍性疾病的影响因素(P<0.05)。结论宫颈癌根治术后患者女性盆底功能障碍(female pelvic fl oor dysfunction,FPFD)发生率高,绝经、便秘、妊娠次数≥3,阴道分娩、留置导尿管时间≥7 d、阴道切除长度≥3 cm是宫颈癌根治术后患者发生FPFD的危险因素,提示护理人员应给予此类患者更多关注,制定盆底康复训练计划,早期评估FPFD的发生,尽早采取有针对性的措施进行干预。
文摘目的系统评价BillrothⅡ式与BillrothⅡ式联合Braun吻合重建术在腹腔镜远端胃癌根治术中的临床疗效差异。方法计算机检索CNKI、VIP、万方数据库、PubMed、Embase、Web of Science等,收集国内外公开发表关于两种消化道重建方式在腹腔镜远端胃癌根治术中比较的临床应用研究。检索时限为2000年1月至2022年10月。对纳入的临床研究进行质量评价及数量提取,并采用Cochrane协作网提供的RevMan5.3统计软件进行Meta分析。结果共纳入9项符合标准的研究,共1483例患者。Meta分析结果显示:在腹腔镜远端胃癌根治术中使用单纯BillrothⅡ式吻合手术时间及消化道重建时间短、术中出血量少,但使用BillrothⅡ联合Braun吻合住院时间短、近期总并发症少、远期反流性疾病少、远期营养状况好,差异均有统计学意义(P<0.05)。而淋巴结清扫数量、首次排气排便时间及部分短期并发症,差异无统计学意义(P>0.05)。结论腹腔镜远端胃癌根治术中,与单纯BillrothⅡ吻合相比,应用BillrothⅡ式联合Braun重建消化道,虽延长手术时间并增加术中出血量,但能减少患者术后近、远期并发症,减少术后住院时间,改善患者远期营养状况,临床应用具有一定优势。
