摘要
目的:探讨胃癌行全胃切除术后空肠代胃术式的生理功能。方法:回顾和分析1990年6月-2000年8月因胃癌手术31例。其中胃底贲门癌经胸腹联合切除8例,行间置空肠代胃(JI)SS型吻合3例,间置空肠代胃(JI)P型5例。胃体癌经腹切除者23例,其中SS型吻合13例,P型10例。两组随访6个月-5年,平均21个月。总结分析两种消化道重建术式的临床资料。结果:SS型和P型术后两组病人观察指标:钡剂排空时间30-60分钟和80-120分钟分别为62.5％、66.7％和37.5％,33.3％;Visick分级指数Ⅰ-Ⅱ级分别为87.7％和86.7％;血浆总蛋白(BLA)分别为73.6±1.1％和74.4±1.3％;血红蛋白(HB)分别为15±1.3和15±1.5;PNI指数分别为54.15和56.1;SS型术后并发返流性食管炎的发生率12.5％。结论:全胃切除术采用SS型和P型间置空肠代胃,恢复食物经过十二指肠通道,对降低全胃切除术后的并发症和提高生活质量具有重要的意义。
Purpose: To evaluate the therapeutic effect of the jejunal interposition reconstruction SS and P type after total gastrectomy in patients with gastric carcinoma. Methods: 31 cases with gastric carcinoma operated on from June, 1990 - Octuber, 2000 were retrospectively analyzed. After total gastrectomy 16 patients were operated by jejunal interposition reconstruction SS type and 15 a jejunal interposition reconstruction P type. The clinic materials of the two types of jejunal interposition reconstruction were assessed by 6 months -5 years follow-up. Results: 30 -60 minutes and 80 - 120 minutes Ba emptying time of SS and P type were 62. 5%, 66. 7% and 37. 5%, 33. 3% respectively ; BLA were 73. 6 + 1. 1% and 74. 4 + 1. 3% , respectively; HB were 15 +1.3 and 15 +1.5; The Visick scoring of the 87. 7% patients with S type and the 86. 7% patients with P type was Ⅰ - Ⅱ grades. Reflux oesophagitis of the patients with S type was 12. 5%. Conclusions: The jejunal interposition reconstruction SS and P type after total gastrectomy are effective means to improve quality of life and to reduce complications after gastrectomy and to maintain the canal of the chyme through the duodenal tract.
出处
《中国癌症杂志》
CAS
CSCD
2002年第6期538-540,共3页
China Oncology
关键词
胃癌
全胃切除
空肠代胃
gastric carcinoma
total gastrectomy
jejunal interposition reconstruction
