CAJ | 학술논문

目的对比观察全胃切除术后P型空肠襻食管空肠Roux-en-Y吻合术(PRY)与非离断式食管空肠改良Roux-en-Y吻合术(URY)对患者营养状态及消化道症状的影响.方法将152例需行全胃切除术的胃癌患者随机分成两组,每组各76例,分别采用PRY和URY术重建消化道,随访12个月比较两组患者的营养状态及消化道症状.结果 PRY组手术时间及术后并发症发生率均大于URY组(均P＜0.05);两组患者12个月后的病死率、体质量变化、血红蛋白、总蛋白、白蛋白均及反流性食管炎发生率差异均有统计学意义(均P＞0.05);术后3个月6个月两组进食量＜300 ml/次者、进食次数＞5次/d及RSS发生率差异有统计学意义(均P＜0.05).结论 URY术式重建消化道可保持肌电传导的连续性,且手术操作较为简便,术后恢复良好,相对PRY术式而言更加合理.
목적 대비관찰전위절제술후P형공장반식관공장Roux-en-Y문합술(PRY)여비리단식식관공장개량Roux-en-Y문합술(URY)대환자영양상태급소화도증상적영향.방법 장152례수행전위절제술적위암환자수궤분성량조,매조각76례,분별채용PRY화URY술중건소화도,수방12개월비교량조환자적영양상태급소화도증상.결과 PRY조수술시간급술후병발증발생솔균대우URY조(균P＜0.05);량조환자12개월후적병사솔、체질량변화、혈홍단백、총단백、백단백균급반류성식관염발생솔차이균유통계학의의(균P＞0.05);술후3개월6개월량조진식량＜300 ml/차자、진식차수＞5차/d급RSS발생솔차이유통계학의의(균P＜0.05).결론 URY술식중건소화도가보지기전전도적련속성,차수술조작교위간편,술후회복량호,상대PRY술식이언경가합리.
Objective To compare total gastrectomy jejunal loop P-type esophagus jejunum Roux-en-Y anastomosis(PRY) and non-type esophageal transection of the jejunum improved Roux-en-Y anastomosis(URY) two different digestion Road reconstruction on the nutritional status of patients and gastrointestinal symptoms. Methods 152patients with total gastrectomy required of gastric cancer patients immediately divided into two groups ,76 patients in each group ,respectively PRY and URY surgical reconstruction of digestive tract, were followed up for 12 months, two groups were compared on nutritional status and gastrointestinal symptoms. Results PRY operation time and postoperative complication rate we re more than URY group(all P ＜0.05) ;two groups 12 months after the mortality and weight changes, hemoglobin, total protein, albumin, and all reflux esophagitis the incidence rate was no significant difference (all P ＞ 0.05); after 3 months and 6 months in both groups food intake ＜ 300ml/second person, eating frequency ＞5 times/d and the difference in the incidence of RSS had statistical significance (all P ＜ 0.05). Conclusion URY surgical reconstruction of digestive tract and maintain the continuity of muscle conduction,and the surgical procedure was simple,a good prognosis and relatively PRY more reasonable in terms of surgical procedures.