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目的探讨胃癌全胃切除术两种重建方式并进行对比分析。方法选取2008年1月至2012年1月采取全胃切除术胃癌患者84例分为常规端侧食管空肠Roux-en-Y吻合术组34例(A组),改良空肠间置代胃术50例(B组),对两组手术过程及术后情况进行观察比较。结果两组患者均顺利完成手术,围术期均未发生吻合口瘘及死亡病例,对两组进行12个月随访,体质量下降均值、血清总蛋白增加均值、白蛋白增加均值、血红蛋白增加均值、进食量恢复百分比均值、进食次数均值、胃肠道症状评分(GSRS)比较,差异有统计学意义(P<0.05)。结论改良空肠间置代胃术具有良好的储袋式代胃功能,更符合生理要求,是一种非常良好的消化道重建方法,值得推荐。
Objective To investigate two reconstruction methods of total gastrectomy for gastric cancer and compare them. Methods From January 2008 to January 2012, 84 cases of total gastrectomy patients with gastric cancer were divided into conventional endoscopic jejunal Roux-en-Y anastomosis in 34 cases (group A), modified jejunal interposition of gastric replacement surgery 50 Cases (B group), the two groups of surgical procedures and postoperative conditions were observed and compared. Results All the patients were successfully performed the operation. There were no cases of anastomotic fistula and death during the perioperative period. The two groups were followed up for 12 months. The average weight loss, the mean serum total protein, the mean albumin, the average hemoglobin increase (P <0.05), the average percentage of recovery of food intake, the average number of meals, and the gastrointestinal symptoms score (GSRS), the difference was statistically significant (P <0.05). Conclusion The modified jejunal interposition gastric bypass has a good function of storage bag instead of stomach, which is more in line with physiological requirements and is a very good method of reconstructing the digestive tract. It is worth recommending.