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目的评价胃肠短拌Ｒｏｕｘ－ｅｎ－Ｙ瓣式吻合术的抗反流效果，探讨Ｒｏｕｘ淤积综合征的防治方法。方法 随访１９８６年１０月至１９９７年６月胃癌切除胃空肠短拌Ｒｏｕｘ－ｅｎ－Ｙ瓣式吻合术１８３例，通过症状调查，按改良Ｖｉｓｉｃｋ标准评级，有症状者借助消化道钡餐、胃镜并活检、Ｂ超、ＣＴ检查排除吻合口狭窄、残胃溃疡和肿瘤复发后，确定短袢Ｒｏｕｘ－ｅｎ－Ｙ瓣式吻合术的抗反流效果及Ｒｏｕｘ淤积综合征的发病率。结果 １７２例（９４．０％）获随访结果，５例不满２年因肿瘤复发死亡，３例术后胃瘫，２例因粘连性肠梗阻接受粘连松解术，２例因腹膜广泛种植转移癌致肠梗阻。可进行改良Ｖｉｓｉｃｋ评级者１６５例，Ⅲ、Ⅳ级者１２例皆为肿瘤复发，未发现有明显症状的反流性胃炎，无倾倒综合征和Ｒｏｕｘ淤积综合征。结论 扩大胃的切除范围，同时缩短Ｒｏｕｘ袢的长度，可防治Ｒｏｕｘ淤积综合征，对空肠空肠吻合口进行抗反流加工，短袢Ｒｏｕｘ－ｅｎ－Ｙ吻合抗反流效果满意。
Objective To evaluate the anti-reflux effect of gastrointestinal short-range Roux-en-Y flap anastomosis and discuss the prevention and treatment of Roux stasis syndrome. METHODS: 183 Roux-en-Y flap anastomoses were resected from gastrojejunostomy from October 1986 to June 1997. Symptoms were scored according to the modified Visick criteria. Symptomatic patients were treated with barium meal, gastroscopy, and biopsy. After anastomotic strictures, residual gastric ulcers, and tumor recurrences were examined with B-ultrasonography and CT scans, the anti-reflux effect of Roux-en-Y flap anastomosis and the incidence of Roux stasis syndrome were determined. Results 172 cases (94.0%) were followed up. 5 cases died of tumor recurrence within 2 years, 3 cases had postoperative stomach cramps, 2 cases received adhesive lysis due to adhesive intestinal obstruction, and 2 cases had extensive metastasis due to peritoneum. Cancer caused intestinal obstruction. There were 165 patients who could be modified Visick’s grading, and 12 patients with grades III and IV had tumor recurrence. No recurrent gastritis with obvious symptoms, no dumping syndrome, and Roux stasis syndrome were found. Conclusions Extending the extent of resection of the stomach, while shortening the length of Roux袢, can prevent Roux stasis syndrome, anti-reflux processing of jejunostomy anastomosis, and the effect of Roux-en-Y anastomosis with anti-reflux is satisfactory.