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目的探讨全胃切除术后消化道重建方式。方法32例患者均以施行全胃切除空肠间置p式襻代胃术。结果全部患者开始进食后均无胸骨后烧灼感及返流现象,进食基本同术前。术后3个月上消化道钡餐照影,取平卧或头低脚高位未见钡迹返流。结论本术式采用的空肠p式襻代胃可以机械性阻挡肠内容物的返流,病人术后短期内恢复饮食,无返流性食管炎发生,生活质量较高。而且进食物可通过十二指肠与胰液、胆汁、十二指肠液充分混合并消化,易于被小肠吸收,避免吸收不良引起营养不良及腹泻。此术式食物在p襻中潴流时间较长,且食管与空肠十二指肠吻合口相距较远,亦可起到阻止碱性肠液返流入食管的作用。故此术式可作为全胃切除术后较好的消化道重建方式。
Objective To investigate the method of digestive tract reconstruction after total gastrectomy. Methods 32 patients underwent total gastrectomy jejunal interposition p style 襻 on behalf of the stomach. Results All patients had no sternal burning sensation and regurgitation after eating. Three months after surgery, upper gastrointestinal barium meal photography, supine or low head high barium no trace of reflux. Conclusion This procedure uses jejunum p style on behalf of the stomach can be a mechanical barrier to intestinal reflux, the patient resume diet shortly after surgery, no reflux esophagitis, higher quality of life. And into the food through the duodenum and pancreatic juice, bile, duodenal juice and fully mixed and digested, easy to be absorbed by the small intestine to avoid malabsorption caused by malnutrition and diarrhea. The surgical food in p 襻 infiltration of a long time, and the esophagus and jejunum duodenum anastomosis far apart, can also play a role in preventing the return of alkaline intestinal fluid into the esophagus. Therefore, the operation can be used as a better gastrectomy digestive reconstruction.