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目的观察保留胃迷走神经远端胃癌根治术疗效及对患者术后营养状况和预后的影响,探讨其临床价值。方法选择胃癌患者80例作为研究对象,均符合远端胃癌根治术手术指证,按照数字随机法分为2组,对照组采取传统手术方式,观察组采取保留胃迷走神经远端胃癌根治术,比较2组疗效及术后营养状况和预后。结果观察组患者手术时间及术中出血量分别为(226.8±45.7)min、(225.1±68.9)ml,与对照组(213.2±39.8)min、(208.9±59.6)ml比较差异均无统计学意义,均P>0.05。观察组肛门首次排气时间为(62.5±9.5)h,明显短于对照组(76.9±8.9)h,P<0.05;观察组餐后上腹饱胀感、食欲下降发生例数分别为5例(12.5%)、5例(12.5%),均低于对照组13例(32.5%)、16例(40.0%),均P<0.05。2组患者术前1 d胃泌素及胰高血糖素水平比较差异均无统计学意义,P>0.05;术后第7天观察组胃泌素及胰高血糖素水平分别为(68.7±11.5)pg/ml、(26.3±3.6)m U/L,显著低于对照组(91.3±12.5)pg/ml、(35.8±3.5)m U/L,差异具有统计学意义,均P<0.05。观察组术后3、6及12个月生活质量评分分别为44.3±4.5、51.3±4.8、55.6±3.9,均高于对照组32.6±5.1、36.9±4.5、40.2±4.3,差异具有统计学意义,均P<0.05。结论保留胃迷走神经远端胃癌根治术疗效较佳,且患者术后营养状况更优,有利于预后。
Objective To observe the curative effect of preserving the gastric vagus distal gastric cancer and its effect on postoperative nutritional status and prognosis of patients with gastric vagal nerve and to explore its clinical value. Methods Eighty patients with gastric cancer were selected as research objects, all of which were in accordance with the surgical indication of radical gastrectomy. According to the digital randomization method, the patients were divided into two groups. The control group was treated by conventional operation. The observation group was treated by radical gastrectomy, Group efficacy and postoperative nutritional status and prognosis. Results The operation time and intraoperative blood loss in the observation group were (226.8 ± 45.7) min and (225.1 ± 68.9) ml, respectively, which were not significantly different from those in the control group (213.2 ± 39.8) and (208.9 ± 59.6) ml , All P> 0.05. In the observation group, the time of the first evacuation of anus was (62.5 ± 9.5) h, which was significantly shorter than that of the control group (76.9 ± 8.9) h, P <0.05. In the observation group, the cases of postprandial abdominal fullness, loss of appetite occurred in 5 cases (12.5%), 5 cases (12.5%) were lower than the control group, 13 cases (32.5%) and 16 cases (40.0%), P <0.05.2 group before the first day of gastrin and pancreatic hyperglycemia (P <0.05). The levels of gastrin and glucagon in observation group were (68.7 ± 11.5) pg / ml and (26.3 ± 3.6) m U / L , Which was significantly lower than that of the control group (91.3 ± 12.5) pg / ml and (35.8 ± 3.5) mU / L, respectively, with statistical significance, all P <0.05. The quality of life scores of observation group at 3, 6 and 12 months after operation were 44.3 ± 4.5, 51.3 ± 4.8 and 55.6 ± 3.9, respectively, which were significantly higher than those in control group (32.6 ± 5.1, 36.9 ± 4.5 and 40.2 ± 4.3) , All P <0.05. Conclusion It is better to keep the gastric vagus nerve distal radical gastrectomy, and the nutritional status of the patients is better after operation, which is benefit to the prognosis.