CAJ | 학술논문

目的：探讨近端胃癌切除术后消化道不同重建方式对患者预后的影响。方法选择2012年8月至2013年12月收治的胃癌患者71例作为研究对象，根据胃癌切除术后消化道不同重建方式分为观察组（n =34）和对照组（n =37）。观察组行食管残胃间空肠间置术，对照组行食管空肠 Roux - en - Y 吻合术，比较两组患者术后并发症发生率、手术时间、血清 C 反应蛋白（CRP）、血清前白蛋白及烧心反流、体重变化评分变化情况。结果两组患者全身炎症反应综合征发生率、术后并发症发生率、CRP 比较差异无统计学意义（ P ﹥0.05）；观察组患者手术时间高于对照组，差异有统计学意义（ P ﹤0.05）；术后3、6个月时观察组 PA 均高于对照组，差异有统计学意义（ P ﹤0.05）；两组患者术后3个月时烧心反流评分比较差异无统计学意义（ P ﹥0.05），术后6个月时观察组显著低于对照组，差异有统计学意义（ P ﹤0.05）；术后3、6个月时观察组体重变化评分均低于对照组，差异有统计学意义（ P ﹤0.05）。结论空肠间置术可较好地解决胃癌切除术患者的胃容量缩小和胃食管反流，促进患者营养恢复及体重改善，值得临床重视。
목적：탐토근단위암절제술후소화도불동중건방식대환자예후적영향。방법선택2012년8월지2013년12월수치적위암환자71례작위연구대상，근거위암절제술후소화도불동중건방식분위관찰조（n =34）화대조조（n =37）。관찰조행식관잔위간공장간치술，대조조행식관공장 Roux - en - Y 문합술，비교량조환자술후병발증발생솔、수술시간、혈청 C 반응단백（CRP）、혈청전백단백급소심반류、체중변화평분변화정황。결과량조환자전신염증반응종합정발생솔、술후병발증발생솔、CRP 비교차이무통계학의의（ P ﹥0.05）；관찰조환자수술시간고우대조조，차이유통계학의의（ P ﹤0.05）；술후3、6개월시관찰조 PA 균고우대조조，차이유통계학의의（ P ﹤0.05）；량조환자술후3개월시소심반류평분비교차이무통계학의의（ P ﹥0.05），술후6개월시관찰조현저저우대조조，차이유통계학의의（ P ﹤0.05）；술후3、6개월시관찰조체중변화평분균저우대조조，차이유통계학의의（ P ﹤0.05）。결론공장간치술가교호지해결위암절제술환자적위용량축소화위식관반류，촉진환자영양회복급체중개선，치득림상중시。
Objective To investigate the effect of different types of reconstruction of digestive tract on prognosis in patients with proximal gastric cancer resection. Methods 71 cases of gastric cancer patients from August 2012 to December 2013 in our hospital were selected as the re-search object. According to resection for gastric cancer of digestive tract after different reconstruction methods,these patients were divided into ob-servation group(n = 34)and control group(n = 37). The observation group was given the esophageal gastric remnant jejunum interposition,the control group was given the Roux - en - Y anastomosis esophageal jejunal. The incidence rate of complications,operation time,serum C reactive protein(CRP),serum pre - albumin and heartburn,reflux,weight change score changes were compared between the two groups. Results The incidence of SIRS,postoperative complications incidence rate and CRP did not have statistically significant difference between the two groups( P﹥ 0. 05). The observation group operation time was(164. 27 ± 18. 15)min,which was higher than the(154. 41 ± 19. 22)min in the control group. The difference was statistically significant( P ﹤ 0. 05). The two group of patients after 3 months heartburn and reflux scores has no signifi-cant difference( P ﹥ 0. 05),after 6 months of observation group was significantly lower than that of the control group,the difference was statisti-cally significant( P ﹤ 0. 05). After 3,6 months,weight change scores of the observation group were lower than the control group,the difference was statistically significant( P ﹤ 0. 05). Conclusion Jejunal interposition can better solve the resection of gastric cancer patients with gastric ca-pacity reduced and gastroesophageal reflux. This method can promote the patient nutritional recovery and weight gain,it is worthy of attention.