目的：研究不同消化道重建术式在胃癌全胃切除术中的临床疗效。方法64例行全胃切除术的胃癌患者,根据不同消化道重建术式分为研究组(33例,采用“p”式空肠袢空肠食管Roux-en-Y吻合术行消化道重建)与参照组(31例,采用袢式Braun 吻合术行消化道重建),比较两组临床疗效、并发症情况。结果采用不同消化道重建术式后,研究组总有效率为96.97%,高于参照组的74.19%,差异具有统计学意义(P<0.05)。研究组发生2例(6.06%)并发症,其中1例(3.03%)倾倒综合征,1例(3.03%)呕吐；参照组发生7例(22.58%)并发症,其中3例(9.68%)倾倒综合征,2例(6.45%)呕吐,2例(6.45%)腹泻；两组并发症发生率比较,差异具有统计学意义(P<0.05)。结论在对胃癌全胃切除术患者展开救治工作时,选用“p”式空肠袢空肠食管Roux-en-Y吻合术行消化道重建的疗效优于袢式Braun 吻合术行消化道重建,前者可在改善质量效果的基础上,充分防治并发症,提升全胃切除术操作流程安全性,可在临床推荐。%ObjectiveTo research clinical effects by different digestive tract reconstruction measures in total gastrectomy for stomach cancer.MethodsA total of 64 stomach cancer patients receiving total gastrectomy were divided by different digestive tract reconstruction measures into research group (33 cases, received “p” type jejunal loop esophagus Roux-en-Y anastomosis for digestive tract reconstruction) and control group (31 cases, received jejunal Braun anastomosis for digestive tract reconstruction). Comparison was made on clinical effects and complications between the two groups.ResultsAfter implement of different digestive tract reconstruction measures, the research group had higher total effective rate as 96.97% than 74.19% in the control group, and the difference had statistical significance (P<0.05). The research group had 2 cases (6.06%) with complications, with 1 dumping syndrome case (3.03%) and 1 emesis case (3.03%). There were 7 cases (22.58%) with complications in the control group, with 3 dumping syndrome cases (9.68%), 2 emesis cases (6.45%) and 2 diarrhea cases (6.45%). The difference of incidence of complications had statistical significance between the two groups (P<0.05). ConclusionIn treating stomach cancer patients who receive total gastrectomy, implement of “p” type jejunalloop esophagus Roux-en-Y anastomosis shows better curative effect in digestive tract reconstruction than jejunal Braun anastomosis. This method can prevent complications and improve safety in total gastrectomy on the basis of improving quality and effect. It is worth clinical recommending.
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