CAJ | 학술논문

目的：探讨管状胃-食管吻合术对食管癌根治术患者生活质量的影响。方法将86例食管癌根治术患者随机分为两组，分别采用管状胃-食管吻合术及全胃-食管吻合术治疗，比较两组患者围术期情况、术后并发症发生率、术后12个月时生活质量评分、满意度及各个测评功能区的评分。结果两组患者手术时间、术中出血量、清扫淋巴结数量、术后引流量及术后住院时间差异均无统计学意义（均 P＞0.05）；研究组患者反流性食管炎（7.0% vs 44.2%）、胸胃综合征（2.3% vs 14.0%）的发生率均低于对照组（均 P＜0.05）；出院后12个月研究组患者的生活质量评分[（82.6±10.4）分 vs（73.8±9.9）分]和满意度（48.8% vs 27.9%）均高于对照组（均P＜0.05）。研究组 FD、SD 测评功能区评分均低于对照组[（14.4±1.2）分 vs（15.3±1.1）分，（14.5±1.2）分 vs （15.6±1.4）分；均 P＜0.05]，AD、MF、SA 测评功能区评分均高于对照组[（21.7±2.3）分 vs（18.9±2.6）分，（12.6±1.1）分 vs（11.8±1.2）分，（8.2±0.7）分 vs（7.6±0.8）分；均 P＜0.05]。结论管状胃-食管吻合术可降低食管癌术后并发症发生率，有效改善患者术后生活质量。
목적：탐토관상위-식관문합술대식관암근치술환자생활질량적영향。방법장86례식관암근치술환자수궤분위량조，분별채용관상위-식관문합술급전위-식관문합술치료，비교량조환자위술기정황、술후병발증발생솔、술후12개월시생활질량평분、만의도급각개측평공능구적평분。결과량조환자수술시간、술중출혈량、청소림파결수량、술후인류량급술후주원시간차이균무통계학의의（균 P＞0.05）；연구조환자반류성식관염（7.0% vs 44.2%）、흉위종합정（2.3% vs 14.0%）적발생솔균저우대조조（균 P＜0.05）；출원후12개월연구조환자적생활질량평분[（82.6±10.4）분 vs（73.8±9.9）분]화만의도（48.8% vs 27.9%）균고우대조조（균P＜0.05）。연구조 FD、SD 측평공능구평분균저우대조조[（14.4±1.2）분 vs（15.3±1.1）분，（14.5±1.2）분 vs （15.6±1.4）분；균 P＜0.05]，AD、MF、SA 측평공능구평분균고우대조조[（21.7±2.3）분 vs（18.9±2.6）분，（12.6±1.1）분 vs（11.8±1.2）분，（8.2±0.7）분 vs（7.6±0.8）분；균 P＜0.05]。결론관상위-식관문합술가강저식관암술후병발증발생솔，유효개선환자술후생활질량。
Objective To investigate the influence of gastric tube gastroesophagostomy on life quality in patients after radical esophagectomy. Method 86 patients that had underwent radical esophagectomy were randomized into two groups, and were treated with gastric tube gastroesophagostomy (study group) or total gastroesophagostomy (con-trol group) each, the perioperative conditions, postoperative complications of the two groups were compared, and quality of life (QoL) in 12 months after surgery, satisfaction and all the other function zones were also scored. Result There were no statistically significant differences between the two groups in regard of operative time, intraoperative blood loss, number of lymph node dissected, postoperative drainage volume and postoperative hospitalization time (P>0.05); For study group vs control group, the occurrence rate of reflux esophagitis (7.0% vs 44.2%, P<0.05) and tho-racic gastric syndrome were lower (2.3% vs 14.0%, P<0.05); And the QoL score [(82.6±10.4) points vs (73.8±9.9) points, P<0.05] and satisfaction degree in 12 months were higher (48.8% vs 27.9%, P<0.05); The scores of function zones by FD [(14.4±1.2) points vs (15.3±1.1) points, P<0.05], SD [(14.5±1.2) points vs (15.6±1.4) points, P<0.05] in study group were all decreased, and the scores of function zones by AD [(21.7±2.3) points vs (18.9±2.6) points, P<0.05], MF [(12.6±1.1) points vs (11.8±1.2) points, P<0.05], and SA [(8.2±0.7) points vs (7.6±0.8) points, P<0.05] were higher than those of the control group. Conclusion The gastric tube gastroesophagostomy shows its advantages in reducing postoperative complications of radical esophagectomy, thus improving the quality of life for patients after surgery.