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目的:分析根治性近端胃癌切除术后应用2种不同吻合方式的近期效果。方法:选取44例行根治性近端全胃切除食管空肠Roux-Y吻合患者作为治疗组Ⅰ,选取同期45例行根治性近端胃大部切除食管残胃间空肠间置患者作为治疗组Ⅱ,观察手术时间、术后不同时间全身炎症反应综合征(SIR)发生率以及C-反应蛋白(CRP)检测情况。结果:治疗组Ⅱ平均手术时间165.38±19.28分钟明显高于治疗组Ⅰ132.43±18.97分钟,P<0.01;2组患者手术并发症分别对比,P>0.05;2组患者在术后2天末、术后4天末、术后6天末SIR发生率对比,P>0.05,而治疗组Ⅱ在CRP术后2天末和术后4天末与治疗组Ⅰ对比,P<0.01,术后6天末对比,P>0.05;2组患者均能够提高前白蛋白在血浆中的浓度和降低体质量评分,但治疗组Ⅱ提高前白蛋白在血浆中的浓度和降低体质量评分幅度明显高于治疗组Ⅰ,P<0.01。结论:根治性近端全胃切除食管空肠Roux-Y吻合术和根治性近端胃大部切除食管残胃间空肠间置术均能达到手术效果,前者手术时间较短,手术并发症较少,但后者能够通过增加残胃容量和降低胃食管反流等机制改善生存质量,更适合中早期近端胃癌患者手术,由于样本较少,且随访不足,值得临床对术式和手术效果进一步探讨。
Objective: To analyze the short-term effect of two different anastomoses after radical resection of proximal gastric cancer. Methods: Forty-four patients undergoing radical proximal gastrectomy for Roux-Y gastroesophageal Roux-Y anastomosis were selected as treatment group Ⅰ. Forty-five patients undergoing radical proximal gastrectomy and esophageal residual gastric jejunal interposition were selected as treatment group Ⅱ The operation time, the incidence of systemic inflammatory response syndrome (SIR) and the detection of C-reactive protein (CRP) at different time points were observed. Results: The average operation time of treatment group Ⅱ was 165.38 ± 19.28 minutes, which was significantly higher than that of the treatment group Ⅰ 132.43 ± 18.97 minutes, P <0.01. The complications of the two groups were compared respectively, P> 0.05; , 4 days after surgery, the incidence of SIR at the end of 6 days after surgery compared, P> 0.05, while the treatment group Ⅱ at the end of 2 days after CRP and 4 days after surgery compared with the treatment group Ⅰ, P <0.01, postoperative 6 days compared to the control, P> 0.05; 2 patients were able to raise prealbumin concentration in the plasma and reduce the body mass score, but the treatment group Ⅱ increased prealbumin concentration in plasma and lower body mass score was significantly higher In treatment group Ⅰ, P <0.01. Conclusion: Radical close gastrectomy esophageal Roux-Y anastomosis and radical proximal gastrectomy esophagogastrostomy can achieve the effect of surgery, the former shorter operative time, fewer surgical complications , But the latter can improve the quality of life by increasing the residual gastric volume and reducing gastroesophageal reflux and other mechanisms is more suitable for patients with proximal and proximal gastric cancer surgery, due to fewer samples and follow-up, it is worth the clinical effect of surgery and surgery further Discussion.