当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2014年
2期
117-118,119
,共3页
胃癌%毕Ⅰ式胃大部切除术%毕Ⅱ式胃大部切除术%术后并发症
胃癌%畢Ⅰ式胃大部切除術%畢Ⅱ式胃大部切除術%術後併髮癥
위암%필Ⅰ식위대부절제술%필Ⅱ식위대부절제술%술후병발증
Gastric cancer%Billroth I%Billroth II%Posroperative complication
目的：通过比较分析胃癌行胃大部切除术后行毕Ⅰ式和毕Ⅱ式重建术后观察并发症的发生情况，探讨其原因及防治原则。方法选择本院2007年4月-2009年7月检出的200例胃癌患者按毕Ⅰ式和毕Ⅱ式胃大切术后分组，并统计并发症的发生情况进而进行回顾性分析。结果残胃病变的发生率在胃大部切除术后行毕Ⅰ式和毕Ⅱ式后高达93.5%，其中胆汁反流在毕I式术后的发生率为17.9%，明显低于毕Ⅱ式术后的发生率69.2%，毕I式术后残胃原发癌、残胃及吻合口炎的发生率分别为5.9%、44.8%，均显著低于毕Ⅱ式术后的36.1%和77.4%的发生率；残胃及吻合口溃疡在毕I式术后的发生率为23.9%，明显高于毕Ⅱ式术后的59.4%（P<0.01）；在两组中其余残胃病变的比较差异无统计学意义（P>O.05）。结论胃大部切除术是治疗胃恶性肿瘤的主要方法，毕I式术后发生并发症的概率要远低于毕Ⅱ式；防治残胃病变尤其是残胃癌，复查内镜及病理是重要措施。
目的：通過比較分析胃癌行胃大部切除術後行畢Ⅰ式和畢Ⅱ式重建術後觀察併髮癥的髮生情況，探討其原因及防治原則。方法選擇本院2007年4月-2009年7月檢齣的200例胃癌患者按畢Ⅰ式和畢Ⅱ式胃大切術後分組，併統計併髮癥的髮生情況進而進行迴顧性分析。結果殘胃病變的髮生率在胃大部切除術後行畢Ⅰ式和畢Ⅱ式後高達93.5%，其中膽汁反流在畢I式術後的髮生率為17.9%，明顯低于畢Ⅱ式術後的髮生率69.2%，畢I式術後殘胃原髮癌、殘胃及吻閤口炎的髮生率分彆為5.9%、44.8%，均顯著低于畢Ⅱ式術後的36.1%和77.4%的髮生率；殘胃及吻閤口潰瘍在畢I式術後的髮生率為23.9%，明顯高于畢Ⅱ式術後的59.4%（P<0.01）；在兩組中其餘殘胃病變的比較差異無統計學意義（P>O.05）。結論胃大部切除術是治療胃噁性腫瘤的主要方法，畢I式術後髮生併髮癥的概率要遠低于畢Ⅱ式；防治殘胃病變尤其是殘胃癌，複查內鏡及病理是重要措施。
목적：통과비교분석위암행위대부절제술후행필Ⅰ식화필Ⅱ식중건술후관찰병발증적발생정황，탐토기원인급방치원칙。방법선택본원2007년4월-2009년7월검출적200례위암환자안필Ⅰ식화필Ⅱ식위대절술후분조，병통계병발증적발생정황진이진행회고성분석。결과잔위병변적발생솔재위대부절제술후행필Ⅰ식화필Ⅱ식후고체93.5%，기중담즙반류재필I식술후적발생솔위17.9%，명현저우필Ⅱ식술후적발생솔69.2%，필I식술후잔위원발암、잔위급문합구염적발생솔분별위5.9%、44.8%，균현저저우필Ⅱ식술후적36.1%화77.4%적발생솔；잔위급문합구궤양재필I식술후적발생솔위23.9%，명현고우필Ⅱ식술후적59.4%（P<0.01）；재량조중기여잔위병변적비교차이무통계학의의（P>O.05）。결론위대부절제술시치료위악성종류적주요방법，필I식술후발생병발증적개솔요원저우필Ⅱ식；방치잔위병변우기시잔위암，복사내경급병리시중요조시。
Objective To investigate the complication of Billroth I and BillrothⅡmethods on the gastric cancer to discuss the causes and prevention. Methods 200 cases of patients with gastric cancer in our hospital,who were detected between 2007 and 2009,were grouped by Billroth I and Billroth II,and were retrospectively analyzed from the aspects of complication. Results The incidence of gastric stump lesion was as high as 93.5%.The incidence of anastomotie,bile reflux in patients with Billroth I was 17.9%apparently lower than 69.2%with BillrothⅡ.The incidences of cancer of the remnant stomach and anastomotie and gastritis of the remnant stomach and were 5.9%,44.8%in patients with Billroth I,and were apparently lower than BillrothⅡ (36.1%,77.4%).The incidence of ulcer of the remnant stomach and anastomotic was 59.4% in patients with BillrothⅡ,and was 23.9%in patients with Billroth I (P<0.01).There were no significant differences found between the other gastric stump lesion of Billroth I and Billroth II (P>0.05).Conclusion The subtotal gastrectomy was the main treatment methods of gastric malignant tumor,peptic ulcer and severe complications.The complications are more in patients with Billroth II than Billroth I.Periodical reexamination for the patients who underwent partial gastrectomy by endoscopy with multiple biopsies is the important measure for detecting gastric stump lesion,and especially for gastric stump cancer.
