空肠间置在腹腔镜近端胃癌根治术中的应用

摘要

Objective To discuss the value of jejuna interposition after laparoscopic assisted proximal stomach cancer radical prostatectomy.Methods The proximal stomach cancer radical prostatectomy assisted with the laparoscopy was used in 57 gastric carcinoma patients (experimental group) and the residual stomach esophagus anastomosis were used for 57 gastric carcinoma patients (control group) between March 2009 and October 2011.The level of hemoglobin at 6 and 12 month,lymphocyte count,serum albumin,nutritional index,Visick classification and postoperative complications were measured before and after operation.Results Before operation,the level of hemoglobin in the experimental and the control group was (109 ± 13)g/L and (108 ± 12)g/L;nutritional index was 35 ± 3 and 36 ± 2.Compared with the level of hemoglobin [(122 ± 14),(115 ± 18) g/L],nutritional index was 50 ±5,43 ±5 six months after operation; the level of hemoglobin was (141 ± 10),(124 ±10)g/L; nutritional index was 57 ± 6,50 ± 5 twelve months after operation; all the differences were statistically significant (P ＜ 0.05).For the post-operative situation,there was a statistical significance in the levels of hemoglobin at 12 months after operation,including the level of nutritional index of 6 and 12 months after operation; the incidence of reflux (experimental group vs control group was 10.8％ (6/57) vs 48.6％ (27/57),(all P ＜ 0.05).Conclusion The jejunum place between the residual stomach and esophagus for patients undergoing proximal stomach cancer radical prostatectomy can maintain and restore physiological functionand reduce serious complications.%目的 探讨空肠间置在腹腔镜近端胃癌根治术中的应用价值.方法 选择内蒙古自治区巴彦淖尔市医院于2009年3月至2011年10月行腹腔镜近端胃癌根治术与食管残胃间空肠间置的胃癌患者57例作为研究组;另有57例行食管残胃直接吻合的胃癌患者作为对照组.比较分析术前、术后6、12个月血红蛋白、淋巴细胞计数、血清清蛋白、营养指数、Visick分级、术后并发症等情况.结果 术前研究组与对照组患者的血红蛋白水平[(109±13)、(108±12)g/L]、营养指数[(35±3)、(36±2)]分别与其术后6个月血红蛋白水平[(122±14)、(115±18)g/L]、营养指数[(50±5)、(43±5)],术后12个月血红蛋白水平[(141±10)、(124±10)g/L]、营养指数[(57±6)、(50±5)]比较,差异均有统计学意义(均P＜0.05);术后12个月血红蛋白、术后6、12个月营养指数、术后反流发生率[研究组10.5％(6/57),对照组47.4％(27/57)],2组比较差异均有统计学意义(均P ＜0.05).结论 对于行近端胃癌根治术的患者,空肠间置于食管与残胃之间,有助于保持与还原患者健康的生理功能,并降低术后严重并发症的发生率.