CAJ | 학술논문

目的探讨改良Braun吻合在全胃切除术后消化道重建术中的应用.方法 60例患者均采用全身麻醉,均经腹入路.全胃切除后,距屈氏韧带50cm以远处行食管-空肠端侧吻合,在距离吻合口40 cm做1个Braun's侧侧吻合,在侧侧吻合口上10 cm输入攀处用7号丝线缝扎肠管,结扎线松紧要适度,可容一血管钳头即可.结果 60例患者术后均进行了随访,随访时间6个月～3年.3例死于术后复发和转移；57例存活,未出现饱胀、排空障碍、反流性食管炎和倾倒综合征等并发症.术后经钡餐检查,口服钡剂经过30、印、120 min后分别有40％、60％、90％由代胃肠袢排出.Visick分级指数为Ⅰ级26例,Ⅱ级34例.结论全胃切除术行改良Braun吻合,其食物储存量和排空时间较为满意.保证了重建消化道神经-肌肉功能的连续性,减少了并发症,提高了患者的生存质量,是一种比较合理的术式.
목적 탐토개량Braun문합재전위절제술후소화도중건술중적응용.방법 60례환자균채용전신마취,균경복입로.전위절제후,거굴씨인대50cm이원처행식관-공장단측문합,재거리문합구40 cm주1개Braun's측측문합,재측측문합구상10 cm수입반처용7호사선봉찰장관,결찰선송긴요괄도,가용일혈관겸두즉가.결과 60례환자술후균진행료수방,수방시간6개월～3년.3례사우술후복발화전이；57례존활,미출현포창、배공장애、반류성식관염화경도종합정등병발증.술후경패찬검사,구복패제경과30、인、120 min후분별유40％、60％、90％유대위장번배출.Visick분급지수위Ⅰ급26례,Ⅱ급34례.결론 전위절제술행개량Braun문합,기식물저존량화배공시간교위만의.보증료중건소화도신경-기육공능적련속성,감소료병발증,제고료환자적생존질량,시일충비교합리적술식.
Objective To investigate the modified Braun anastomosis in reconstruction after total gastrectomy surgery of the digestive tract.Methods Sixty routine total gastrectomy patients underwent jejunostomy loop behalf of the stomach modified Braun-style match.Surgery will do a loop-type jejunum Braun' s side to side anastomosis,side to side anastomosis in the 10 cm,with 7 silk suture input climbing round.Results Sixty patients had postoperative follow-up for 6 months to 3 years,3 patients died of recurrence and metastasis.Fifty-seven cases of survival,did not appear fullness,emptying,reflux esophagitis and dumping syndrome and other complications; Postoperative barium meal examination,30,60,120 min after oral administration of barium,respectively,after 40％,60％,90％ of the discharge by the generation of gastrointestinal loop.Visick grading index:26 cases of grade Ⅰ,34 cases of grade Ⅱ.Conclusions Total gastrectomy with modified Braun anastomosis,has good food storage capacity and emptying time.It can reconstruct of the digestive tract to ensure the continuity of nerve muscle function,reduce complications and improve quality of life of patients,is a reasonable surgery.