改良空肠间置术在近端胃癌根治术中应用的临床研究

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1、改良空肠间置术在近端胃癌根治术中应用的临床研究（赣州市肿瘤医院肿瘤科赣州341000）摘要目的：探讨改良空肠间置术在近端胃癌根治术中应用价值。方法：选取我院择期行近端胃癌根治术患者65例，根据不同消化道重建方式将患者分为观察组（30例，行改良空肠间置术）和対照组（35例，行食管残胃吻合术），比较两组患者手术时间、术屮出血量、术后并发症、术后2月后营养、体重状况和反流性食管炎症状差界。结果：观察组手术时间明显高于对照组，两组比较差异具有统计学意义（P0.05）；术后2个月观察组患者血红蛋白水平、总淋巴细胞计数均明显高于对照组，休重变化评分

2、、反流严重程度评分均明显低于対照组，两组比较差异均具有显著性（P0.05）。结论：与对照组相比，改良空肠间置术能明显改善患者营养和反流症状，可应用于近端胃癌根治术患者的消化道重建。关键词改良空肠间置术胃癌根治术中图分类号：R730.56；R735.2文献标识码:B文章编号:1006-1533（2014）17-0048-03Clinicalstudyontheapplicationofmodifiedjejunalinterpositioninproximalgastriccancerradicalsurgery*CAILianming*

3、*(DepartmentofOncology,theCancerHospitalofGanzhouCity,Jiangxi341000,China)ABSTRACTObjective：Toinvestigatetheapplicationvalueofmodifiedjejunalinterpositioninproximalgastriccancerradicalsurgery.Methods：Sixty-fivecasesofpatientswithgastriecancer,whowereundergoingproximalgas

4、trectomyinourhospital,wereselectedanddividedintoanobservationgroup(30caseswithmodifiedjejunalinterposition)andacontrolgroup(35caseswithosophagogastrostomy)basedonthedifferentproceduresofalimentarytractreconstruction,andoperationtime,intraoperativebleedingvolume,postopera

5、tivecomplications,nutritionandweightstatusandthesymptomsofrefluxesophagitiswerecomparedbetweentwogroups.Results：Theoperationtimewasmuchlongerintheobservationgroupthaninthecontrolgroup,whichshowedastatisticalsignificanee(P0.05).Hemoglobinievelandtotallymphocytecountaftert

6、womonthsofoperationweresignificantlyhigherintheobservationgroupthaninthecontrolgroup,whilethechangeofbodyweightandthescoreofregurgitationseverityweresignificantlylowerintheobservationgroupthaninthecontrolgroup,thedifferencesweresignificant(P0.05).Conclusion：Themodifiedje

7、junalinterpositionoperationcanobviouslyimprovethenutritionandrefluxsymptomsofpatientsandbeappliedtothereconstmetionofdigestivetractintheKEYWORDSmodifiedpatientsundergoingproximalgastrectomy.jejunalinterposition；radicalresection；gastriccancer胃癌是常见恶性肿瘤，近端胃癌发病率逐年增加，根治性手术是治疗

8、胃癌的首选方式。根治性手术有近端胃切除术和全胃切除术，在手术切除边缘足够的前提下次全近端胃切除术的远期疗效明显优于全近端胃切除术患者，十二指肠入路重建术的效果明显优于非十二指肠入路手术患者[1]o但近端胃切