管状胃食管吻合术与全胃代食管吻合术对食管癌患者术后食管反流及生活质量的对比研究

摘要

目的：探讨管状胃食管吻合术与全胃代食管吻合术对食管癌患者术后食管反流及生活质量的影响。方法将收治的60例食管癌患者分为研究组和对照组各30例，研究组采用管状胃食管吻合术，对照组采用全胃代食管吻合术；术后随访24周，对比两组患者生活质量、胃食管反流及肺部功能的变化情况。结果两组患者术后主要并发症有肺部感染、胸腔感染、吻合口瘘、残胃瘘等，其中研究组发生率为10．0％，对照组为13．3％，两组相比差异无统计学意义（χ2＝0．529，P ＞0．05）。术后12周及24周研究组生活质量评分显著高于对照组，两组间相比差异具有统计学意义（P ＜0．05）；研究组术后4周、12周 RDQ 评分显著低于对照组（P ＜0．05），术后两组患者肺功能各指标均明显降低，其中研究组最大通气量（MMV）、一秒钟用力呼气容积（FEV1．0）、肺活量（VC）显著优于对照组，两组间相比差异有统计学意义（P ＜0．05）。结论管状胃食管吻合术可以显著改善患者胃食管反流和肺部功能，提高患者的生活质量，值得临床推广应用。%Objective To explore the effect of gastroesophageal reflux and life quality of the whole stomach e-sophagus anastomosis tubular stomach esophagus anastomosis.Methods Sixty patients with esophageal carcinoma were divided into study group and control group,and each group with 30 cases,the study group used the tubular stomach esophagus anastomosis,the control group used the whole stomach esophagus anastomosis;Patients were fol-lowed up for 24 weeks,life quality,gastroesophageal reflux and pulmonary function of the two groups were com-pared.Results The main postoperative complications in the two groups were pulmonary infection,pleural infection, anastomotic fistula,gastric stump fistula,the incidence rate of the study group was 10%,and that of the control group was 13.3%,two groups had no significant difference(χ2 =0.529,P >0.05);The life quality scores of the pa-tients in the study goup after operation12 and 24 weeks was significantly higher than that in the control group,the difference was statistically significant(P <0.05);RDQ score in the study group after operation 4 week,12 week was significantly lower than that of the control group(P<0.05),all indexes of lung function in the two groups were sig-nificantly decreased;maximal ventilatory volume(MMV),forced expiratory volume in one second(FEV1.0),vital ca-pacity(VC)in the study group were significantly better than the control group,differences were statistically signifi-cant(P <0.05).Conclusion The tubular stomach esophagus anastomosis can significantly improve gastroesophageal reflux and lung function,improve the quality of life in patients,and worthy of clinical application.