全胃切除术后两种Roux-en-Y消化道重建方式疗效比较

摘要

目的：：探讨全胃切除术后单纯Roux-en-Y吻合和P式Roux-en-Y吻合两种消化道重建方式的临床效果。方法：回顾性分析2012年1月至2014年12月期间我院48例胃癌患者全胃切除术后分别行单纯Roux-en-Y吻合(24例)和P式Roux-en-Y吻合法(24例)两种消化道重建方式患者临床资料,比较患者术后Roux潴留综合症( RSS)、碱性返流性食管炎、营养状况指标的差异。结果： P式Roux-en-Y吻合组和单纯Roux-en-Y吻合组在患者碱性返流性食管炎发生率无统计学差异(P>0.05),但P式Roux-en-Y吻合组患者术后的Roux潴留综合征(RSS)发生率、术后3个月及12个月患者营养指标营养状况指标较单纯Roux-en-Y吻合组好(P<0.05)。结论：相对于全胃切除术后的单纯Roux-en-Y吻合术,P式Roux-en-Y吻合术具有较好的贮袋代胃作用,提高了患者术后的生活质量,是全胃切除术后一种较理想的消化道重建术式。%Objective:To explore the clinical effects of the two ways of simple Roux-en-Y and P-type Roux-en-Y of digestive tract reconstruction after total gastrectomy. Methods:To retrospectively analyze 48 cases clinical data of patients with gastric cancer by two ways of simple Roux-en-Y and P-type Roux-en-Y of digestive tract reconstruction after total gastrectomy in our hospital from January 2012 to December 2014 and compare Roux retention in postoperative patients with syndrome ( RSS) ,alkaline reflux esophagitis,and the differences in nutritional status indicators. Results:There was no significant difference among patients with alkaline reflux esophagitis incidence rate by P-type Roux-en-Y anastomosis and pure Roux-en-Y (P>0. 05),but the rates of P-type Roux-en-Y retention in post-operative patients with Roux-Y stasis syndrome after gastrectomy ( RSS) and the patients’ nutritional indicator after three months and even twelve months as well as nutrition indicators Roux Group were performed very well (P<0. 05). Conclusion:Compared to simple Roux-en-Y anastomosis after total gastrectomy,P-Roux-en-Y pouch gastric anastomosis has good effect and can improve patients’ quali-ty of life,so it is an ideal digestive tract procedure after total gastrectomy.