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目的 探讨理想的全胃切除术后的重建方式。方法 对 1987～ 1999年经病理证实行全胃切除术胃恶性肿瘤 45例进行回顾性分析。保留幽门结肠代胃术 2 1例 ,间置结肠代胃 2 4例 ,观察术后并发症、Visick指数、血浆营养参数、全血细胞计数、代胃的储存及排空功能、体重变化。结果 术后体重恢复好 ,血浆营养参数高。 88.9%的术后病人的Visick指数为Ⅰ～Ⅱ ,保留幽门的结肠代胃术有更高存留时间 ,更少的食管返流。结论 胃恶性肿瘤全胃切除术后消化道重建结肠代胃保证摄入食物通过十二指肠。结肠代胃是较理想的术式 ,保留幽门的结肠代胃更佳。
Objective To investigate the ideal reconstruction method after total gastrectomy. Methods A retrospective analysis of 45 cases of gastric cancer with total gastrectomy performed from 1987 to 1999 was performed. Gastrointestinal pyloric colon replacement was performed in 21 cases, and colonic replacement was performed in 24 cases. Postoperative complications, Visick index, plasma nutritional parameters, complete blood counts, replacement and emptying function of stomach replacement, and body weight were observed. Results The weight recovered well after surgery and the plasma nutrition parameters were high. In 88.9% of postoperative patients, the Visick index was I ~ II. The pylorus-preserving colonic gastrectomy had higher survival time and less esophageal reflux. Conclusion Gastric malignancy After total gastrectomy, the digestive tract reconstructs the colon colon to ensure the intake of food through the duodenum. The colon replacement stomach is an ideal surgical procedure, and the pylorus colon is better for the stomach.