目的：探讨全胃切除食管空肠 Roux‐Y 吻合术和单腔空肠间置术患者消化道动力的变化，并加以比较，为今后临床行全胃切除术后治疗方法提供依据。方法选取2010年1月至2013年6月在重庆市合川区人民医院行全胃切除术生存期达6个月的126例患者作为研究对象，将患者分为两组，观察组（63例）和对照组（63例），另外设63例健康人群作为健康组，对照组给予单腔空肠间置术，观察组行食管空肠 Roux‐Y 吻合术，健康组不施加干预。观察3组在消化道动力方面的不同表现，并加以比较。结果观察组患者体质量、每日进餐次数、每日进食量少于对照组，差异有统计学意义（P＜0．05），两组与健康组比较差异无统计学意义（P＞0．05）。观察组患者出现反流性食管炎、倾倒综合征、嗳气、早饱症等不良反应的人数明显高于对照组，差异有统计学意义（P ＜0．05），两组与健康组比较差异无统计学意义（P ＞0．05）。3组研究对象营养学指标差异无统计学意义（P ＞0．05）。结论Roux‐Y 吻合术营养状况的改善情况不次于单腔空肠间置术，但术后不良反应较多。因此，应根据患者具体情况选择适宜的重建术方法，但应以单腔空肠间置术作为首选方法。%Objective To investigate and compare the changes of the dynamics in digestive tract in patients re‐spectively received esophagus jejunum Roux‐Y anastomosis and single pouch jejunum interposition after total gastrec‐tomy ,so as to provide a reference for the treatment after total gastrectomy .Methods From January 2010 to June 2013 ,126 patients with 6‐month survival after total gastrctomy were selected in Hechuan District People′s Hospital and divided into two groups :observation group (n= 63) and control group (n= 63) .63 healthy people were enrolled in normal group at the same time .The patients of control group and observation group were treated by single pouch jejunum interposition and esophagus jejunum Roux‐Y anastomosis ,respectively .Normal group did not exert interven‐tion .The performance of dynamics in digestive tract in three groups were observed and compared .Results Compared with control group ,the weight ,the number of meals per day ,the daily food intake significantly reduced (P< 0 .05) , however ,neither control group nor observation group was significantly different from normal group (P > 0 .05) .In observation group ,the numbers of people with adverse reactions ,such as reflux esophagitis ,dumping syndrome ,belc‐hing and early satiety disease ,were significantly more than control group (P< 0 .05) ,however ,neither control group nor observation group was significantly different from normal group (P> 0 .05) .There was no significant difference of nutrition indicators among three groups (P> 0 .05) .Conclusion The improvement of digestive tract dynamics in patients with esophagus jejunum Roux‐Y anastomosis was as good as the patients with single pouch jejunum interpo‐sition ,however ,patients with esophagus jejunum Roux‐Y anastomosis had more adverse reactions after surgery .Suit‐able reconstruction method should be chose ,according to the patient′s situation ,and single pouch jejunum interposi‐tion should be the preferred method .
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