CAJ | 학술논문

目的：探讨管状胃的改良方法及其在食管胸中下段癌手术中的应用效果。方法选取2009年10月~2013年12月衡水市哈励逊国际和平医院胸外科收治的食管胸中下段癌患者213例，根据手术方法不同将其分为改良管状胃组(n=108)和管状胃组(n=105)，改良管状胃组制作改良管状胃，管状胃组制作管状胃。观察两组患者手术时间、术后吻合口瘘发生率、术后残胃出血量、住院时间。结果两组患者均顺利完成手术，管状胃组术后死亡1例，发生吻合口瘘1例，改良管状胃组无死亡及吻合口瘘病例。改良管状胃组手术时间[(147.89±11.32)min]少于管状胃组[(172.72±11.76)min]，差异有高度统计学意义(t=6.453，P=0.000)。改良管状胃组术后残胃出血量[(371.33±99.13)mL]少于管状胃组[(456.89±109.62)mL]，差异有统计学意义(t=2.456，P=0.019)。改良管状胃组术后住院时间[(14.78±3.72)d]与管状胃组[(15.89±4.09)d]比较；差异无统计学意义(t=0.853，P=0.399)。结论改良管状胃在食管胸中下段癌手术中可减少手术时间及术后残胃出血量，是基层医院治疗食管胸中下段癌疗效更好的手术方法，具有较好的临床应用价值。
목적：탐토관상위적개량방법급기재식관흉중하단암수술중적응용효과。방법선취2009년10월~2013년12월형수시합려손국제화평의원흉외과수치적식관흉중하단암환자213례，근거수술방법불동장기분위개량관상위조(n=108)화관상위조(n=105)，개량관상위조제작개량관상위，관상위조제작관상위。관찰량조환자수술시간、술후문합구루발생솔、술후잔위출혈량、주원시간。결과량조환자균순리완성수술，관상위조술후사망1례，발생문합구루1례，개량관상위조무사망급문합구루병례。개량관상위조수술시간[(147.89±11.32)min]소우관상위조[(172.72±11.76)min]，차이유고도통계학의의(t=6.453，P=0.000)。개량관상위조술후잔위출혈량[(371.33±99.13)mL]소우관상위조[(456.89±109.62)mL]，차이유통계학의의(t=2.456，P=0.019)。개량관상위조술후주원시간[(14.78±3.72)d]여관상위조[(15.89±4.09)d]비교；차이무통계학의의(t=0.853，P=0.399)。결론개량관상위재식관흉중하단암수술중가감소수술시간급술후잔위출혈량，시기층의원치료식관흉중하단암료효경호적수술방법，구유교호적림상응용개치。
Objective To investigate the modify method of gastric tube and observe the clinical application effect of modified gastric tube in surgery of middle and lower thoracic esophageal cancer. Methods A total of 213 patients with middle and lower thoracic esophageal cancer who underwent esophagectomy from October 2009 and December 2013 in Harrison International Peace Hospital of Hengshui. They were divided into the modified gastric tube group (n=108) and gastric tube group (n=105) according to the operation method. The modified gastric tube group was given the modified gastric tube. The gastric tube group was given the gastric tube. The operation time, rate of anastomotic leakage, bleed-ing amount of remnant gastric postoperative operation, and length of stay in hospital of two groups were observed. Re-sults All surgeries in the two groups were successfully performed. There was 1 death case and 1 case with anastomotic leakage in the gastric tube group, there was no death case and anastomotic leakage case in the modified gastric tube group. There were statistically differences in the operation time [(147.89±11.32) v s (172.72±11.76) min, t=6.453, P=0.000] and bleeding amount of remnant gastric postoperative operation [(371.33±99.13) v s (456.89±109.62) mL, t=2.456, P=0.019] between two groups. There was no statistically difference in the length of stay in hospital [(14.78±3.72) v s (15.89±4.09) d, t=0.853, P=0.399] between the two groups. Conclusion Modified gastric tube has a good value in clinical application with less operation time and bleeding amount of remnant gastric postoperative operation. It is a better way to treat middle and lower thoracic esophageal cancer in surgeries, especially for basic hospital.