CAJ | 학술논문

目的：探讨幽门成形在贲门胃底部占位性病变行近端胃大部分切除术后的临床效果。方法对2010～2013年重庆医科大学附属第二医院胃肠外科收治的贲门胃底病变患者100例进行前瞻性随机对照试验研究，按照排除标准排除6例，其余94例患者分组，对照组（B 组）40例单纯行近端胃大部分切除，试验组（A 组）54例患者附加幽门成形，两组均无失访病例。观察比较两组术后住院期间临床观察指标、远期并发症及术后3个月时复查胃镜提示幽门狭窄及反流性食管炎情况。结果两组患者住院期间胃瘫发生率差异无统计学意义（P ＞0．05），其余住院期间各观察指标及远期并发症发生率差异有统计学意义（P ＜0．05）。结论近端胃大部分切除附加幽门成形可减少胃潴留及反流性食管炎的发生，减少住院时间，有利于患者术后恢复，适合临床推广应用。
목적：탐토유문성형재분문위저부점위성병변행근단위대부분절제술후적림상효과。방법대2010～2013년중경의과대학부속제이의원위장외과수치적분문위저병변환자100례진행전첨성수궤대조시험연구，안조배제표준배제6례，기여94례환자분조，대조조（B 조）40례단순행근단위대부분절제，시험조（A 조）54례환자부가유문성형，량조균무실방병례。관찰비교량조술후주원기간림상관찰지표、원기병발증급술후3개월시복사위경제시유문협착급반류성식관염정황。결과량조환자주원기간위탄발생솔차이무통계학의의（P ＞0．05），기여주원기간각관찰지표급원기병발증발생솔차이유통계학의의（P ＜0．05）。결론근단위대부분절제부가유문성형가감소위저류급반류성식관염적발생，감소주원시간，유리우환자술후회복，괄합림상추엄응용。
Objective To explore the clinical effects of pyloroplasty on proximal gastrectomy in patients with lesions in cardia of the bottom of stomach.Methods One hundred cases of the proximal gastric diseases who were enrolled in the second affiliated hos-pital of Chongqing medical university from the January 2010 to December 2013 were selected in this prospective randomized con-trolled experimental study.Among them,6 cases were excluded,and the other 94 cases were divided into two groups:the experimen-tal group (A),in which 54 patients were underwent additional pyloroplasty surgery;the control group (B),in which 40 patients were underwent with no strings attached pyloroplasty.All patients were followed up.Then,the clinical indicators during hospitaliza-tion,term complications and repeated endoscopy prompted pyloric stenosis and reflux esophagitis situation three months after dis-charged from hospital were observed.Results There was no significant difference in the incidence rate of gastroplegia (P >0.05);there were significant differences in other clinical indicators during the postoperative hospitalization and the incidence rate of compli-cations (P <0.05).Conclusion Proximal gastrectomy additional pyloroplasty could reduce gastric retention,decrease the incidence of reflux esophagitis,shorten the hospital period and could be helpful for recovery,thus it is recommended to be further promoted.