实用肿瘤学杂志 ›› 2015, Vol. 29 ›› Issue (2): 97-101.doi: 10.11904/j.issn.1002-3070.2015.02.001

• 论著 •    下一篇

近端胃癌消化道重建术式改良临床观察的研究

武迪,薛英威,张洪峰   

  1. 哈尔滨医科大学附属肿瘤医院胃肠外科(哈尔滨 150081)
  • 收稿日期:2014-09-18 出版日期:2015-04-28 发布日期:2015-05-05
  • 通讯作者: 张洪峰,E-mail:zhf1133@163.com E-mail:zhf1133@163.com
  • 作者简介:武迪,男,(1988-),硕士研究生,从事胃肠肿瘤外科方向的研究
  • 基金资助:
    黑龙江省博士后资助基金(LBH-Z09007);黑龙江省科技计划项目攻关课题(GC09C405-3)

Clinical observation of improvement on reconstruction of alimentary tract for proximal gastric cancer

WU Di,XUE Yingwei,ZHANG Hongfeng   

  1. Department of Gastrointestinal Surgery,The Affiliated Tumor Hospital of Harbin Medical University,Harbin 150081,China
  • Received:2014-09-18 Online:2015-04-28 Published:2015-05-05

摘要: 目的 探讨近端胃癌术后消化道重建的理想术式。方法 选取2012年5月—2014年1月哈尔滨医科大学附属肿瘤医院收治的近端胃癌111例,按手术方法分为改良组(食管-管状胃吻合)和传统组(食管-残胃吻合),追踪随访术后并发症的发生率并对患者术后的生活质量应用欧洲癌症研究与治疗组织(EORTC)制定的QLQ-C30量表及QLQ-STO22量表进行统计学分析。结果 两组患者术后随访期内均未出现死亡病例,两组患者在手术时间、术中出血量及术后一个月的体重变化上无统计学意义,在术后六个月体重变化上有统计学意义,改良组要优于传统组。在对EORTC QLQ-C30量表和QLQ-STO22量表进行分析后,在恶心呕吐、吞咽困难、疼痛及返流方面具有统计学意义,改良组优于传统组,其余无统计学意义。结论 相比传统组,改良组可以有效减少术后恶心呕吐、吞咽困难、疼痛和返流等并发症的发生率,能有效改善术后患者的生活质量,可作为近端胃切除后消化道重建的提倡术式。

Abstract: Objective To explore the improvement of the digestive tract reconstruction surgery of postoperative proximal gastric cancer.Methods One hundred and eleven patients were chosen in our hospital from May 2012 to January 2014,and were divided into modified group(gastric tube-esophageal anastomosis)and traditional group(remnant stomach-esophageal anastomosis).Following-up visits were carried out for the incidence of postoperative/complications,and the postoperative quality of life was analyzed with EORTC QLQ-C30 and QLQ-STO22.Results There was no death case in both groups in the postoperative following-up period.The duration of operation,amount of bleeding during operation and weight changes after a month of the both groups were no statistical significance.However,there was statistical significance in weight changes after operation 6 months,and the results of modified group was better than traditional group.By analyzing the EORTC QLQ-C30 and QLQ-STO22,there was statistical significance in nausea and vomiting,dysphagia,pain,reflux,and the results of modified group was better than traditional group,there were no statistical significances of others.Conclusion Compared with the traditional group,modified group can decrease postoperative nausea and vomiting,dysphagia,pain,reflux and improve the patients′postoperative quality of life effectively.It is recommended for digestive tract reconstruction after proximal gastrectomy excision.

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