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目的:探讨胃癌近端胃大部切除术后理想的消化道重建方式。方法:回顾性分析我院近年来收治的35例胃癌患者的临床资料,根据消化道重建方式不同,将患者随机分为对照组和观察组,对照组采用食道残胃直接吻合术,观察组采用食道残胃间空肠间置重建术,比较2组患者的手术时间、术中出血量、并发症发生率及术后生存质量、营养状况。结果:观察组患者的手术时间为(201.3±32.4)min,明显多于对照组的(145.8±23.5)min(P<0.05);观察组患者并发症发生率为33.33%,低于对照组患者并发症发生率64.71%(P<0.05)。而对照组患者术后烧心感觉明显多于观察组(P<0.05)。结论:食道残胃间空肠间置重建术可以显著减少胃癌近端胃大部切除术后反流性食管炎的发生,减少患者烧心的症状,是理想的消化道重建术式,值得临床推广使用。
Objective: To explore the ideal method of gastrointestinal reconstruction after proximal gastrectomy of gastric cancer. Methods: The clinical data of 35 cases of gastric cancer treated in our hospital in recent years were retrospectively analyzed. According to the different ways of digestive tract reconstruction, the patients were randomly divided into control group and observation group. The control group was treated with direct esophageal gastric anastomosis. The observation group was adopted Esophageal remnant gastrointestinal jejunal reconstruction, the operation time, intraoperative blood loss, the incidence of complications and postoperative quality of life, nutritional status were compared between two groups. Results: The operation time in the observation group was (201.3 ± 32.4) min, which was significantly higher than that in the control group (145.8 ± 23.5) min (P <0.05). The incidence of complications in the observation group was 33.33%, which was lower than that in the control group The complication rate was 64.71% (P <0.05). Patients in the control group had significantly more heartburn after operation than those in the observation group (P <0.05). Conclusion: Esophageal remnant gastrointestinal jejunal reconstruction can significantly reduce the occurrence of reflux esophagitis after proximal gastrectomy and reduce the symptoms of heartburn in patients, which is an ideal method of gastrointestinal reconstruction and is worthy of clinical promotion .