胃癌根治术中应用不同消化道重建方式对术后并发症及胆囊收缩功能的影响
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摘要
目的:探讨不同消化道重建方式对胃癌根治术患者术后并发症及胆囊收缩功能的影响。方法:选择2014年1月至2017年2月收治的74例行胃癌根治术患者为研究对象,随机分为B-Ⅱ组和双通道重建两组,每组37例患者,B-Ⅱ组患者进行Billroth-Ⅱ式重建,双通道重建组患者进行调节型双通道重建,对两组患者术后并发症及胆囊收缩功能进行观察。结果:B-Ⅱ组患者术后并发症发生率为21.62%,高于双通道重建组的5.41%(P<0.05);B-Ⅱ组患者术后胆囊排空率下降,胆囊容积、血清CCK水平较术前上升(P<0.05),双通道重建组患者术后胆囊容积、血清CCK与术前比较,差异无统计学意义(P>0.05),胆囊排空率增高(P<0.05)。结论:胃癌根治术中应用调节型双通道重建能减少术后并发症发生率,也能促进术后胆囊收缩功能恢复,值得临床推广。
Objective: To explore the influence of different digestive tract reconstruction methods in radical resection of gastric cancer on postoperative complications and gallbladder contraction function. Methods: 74 patients with gastric cancer hospitalized from January 2014 to February2017 were chosen and randomly divided into the B-Ⅱ group and the two-channel reconstruction group,with 37 patients in each group. The B-Ⅱ group underwent Billroth II reconstruction,while the two-channel reconstruction group underwent double channel reconstruction,the complications and gallbladder contraction function after operation observed. Results: The complication rate after the operation in the B-Ⅱ group was21. 62 %,which was significantly higher than that in the two-channel reconstruction group( 5. 41 %)( P < 0. 05); After operation,the gallbladder emptying rate was decreased,the gallbladder volume and the level of serum CCK were higher than those before operation( P < 0. 05);there was no difference in the gallbladder volume and the serum CCK after operation in the two-channel reconstruction group( P > 0. 05),but the gallbladder emptying rate was increased( P < 0. 05). Conclusion: The double channel reconstruction in radical resection of gastric cancer can reduce the incidence of postoperative complications and promote the recovery of gallbladder contraction function,worthy of clinical promotion.
Objective: To explore the influence of different digestive tract reconstruction methods in radical resection of gastric cancer on postoperative complications and gallbladder contraction function. Methods: 74 patients with gastric cancer hospitalized from January 2014 to February2017 were chosen and randomly divided into the B-Ⅱ group and the two-channel reconstruction group,with 37 patients in each group. The B-Ⅱ group underwent Billroth II reconstruction,while the two-channel reconstruction group underwent double channel reconstruction,the complications and gallbladder contraction function after operation observed. Results: The complication rate after the operation in the B-Ⅱ group was21. 62 %,which was significantly higher than that in the two-channel reconstruction group( 5. 41 %)( P < 0. 05); After operation,the gallbladder emptying rate was decreased,the gallbladder volume and the level of serum CCK were higher than those before operation( P < 0. 05);there was no difference in the gallbladder volume and the serum CCK after operation in the two-channel reconstruction group( P > 0. 05),but the gallbladder emptying rate was increased( P < 0. 05). Conclusion: The double channel reconstruction in radical resection of gastric cancer can reduce the incidence of postoperative complications and promote the recovery of gallbladder contraction function,worthy of clinical promotion.
引文
[1]郭康,周脉耕,潘晓平等.中国居民2006-2012年胃癌死亡趋势分析[J].中国公共卫生,2015,31(3):341-343.
[2]张维汉,吴春成,宋小海,等.远端胃癌切除术不同消化道重建方式术后恢复指标和术后一年上消化道内镜评估结果的比较[J].中华胃肠外科杂志,2016,19(2):216-220.
[3]中华医学会消化内镜学分会,中国抗癌协会肿瘤内镜专业委员会.中国早期胃癌筛查及内镜诊治共识意见(2014年,长沙)[J].中华消化内镜杂志,2014,31(7):361-377.
[4]Hu WQ,Fang M,Zhao HL,et al.Tumor invasion unit in gastric cancer revealed by QDs-based in situ molecular imaging and multispectral analysis[J].Biomaterials,2014,35(13):4125-4132.
[5]黄兴宇,韩仁强,滕支梅,等.2003-2012年江苏省胃癌发病死亡及农村地区生存情况分析[J].中华疾病控制杂志,2017,21(5):482-486.
[6]阚炳华,燕归如,申武峰,等.不同消化道重建术治疗贲门癌的临床效果对比[J].实用癌症杂志,2016,31(8):1283-1286.
[7]吴宸,姜淮芜,彭方兴,等.胃癌手术不同消化道重建方式对患者术后胆囊收缩功能的影响[J].海南医学,2016,27(3):381-383.
[8]邓先锐,徐国宏,岳文杰,等.保留胃窦空肠间置双通道手术与传统消化道重建对胃食管结合部癌患者生存质量及预后的影响对比[J].河北医学,2015,21(8):1423-1426.
[9]邹贵军,胡时栋,王迪,等.全腹腔镜远端胃癌根治术后消化道重建方式的对比[J].腹腔镜外科杂志,2016,21(11):820-823.
[10]李伟学,曾涛.不同消化道重建方案在胃癌手术患者中的应用效果[J].安徽医药,2015,19(8):1569-1570.
[11]孙海滨,田永静,宝音升博尔,等.间置空肠术与两种常见消化道重建方式对近端胃癌术后生活质量影响的对比研究[J].中国医药导报,2016,13(11):112-116.
[12]杨玉兵.全胃切除患者术后不同消化道重建方式对营养代谢的影响[J].重庆医学,2016,45(8):1077-1079.
[2]张维汉,吴春成,宋小海,等.远端胃癌切除术不同消化道重建方式术后恢复指标和术后一年上消化道内镜评估结果的比较[J].中华胃肠外科杂志,2016,19(2):216-220.
[3]中华医学会消化内镜学分会,中国抗癌协会肿瘤内镜专业委员会.中国早期胃癌筛查及内镜诊治共识意见(2014年,长沙)[J].中华消化内镜杂志,2014,31(7):361-377.
[4]Hu WQ,Fang M,Zhao HL,et al.Tumor invasion unit in gastric cancer revealed by QDs-based in situ molecular imaging and multispectral analysis[J].Biomaterials,2014,35(13):4125-4132.
[5]黄兴宇,韩仁强,滕支梅,等.2003-2012年江苏省胃癌发病死亡及农村地区生存情况分析[J].中华疾病控制杂志,2017,21(5):482-486.
[6]阚炳华,燕归如,申武峰,等.不同消化道重建术治疗贲门癌的临床效果对比[J].实用癌症杂志,2016,31(8):1283-1286.
[7]吴宸,姜淮芜,彭方兴,等.胃癌手术不同消化道重建方式对患者术后胆囊收缩功能的影响[J].海南医学,2016,27(3):381-383.
[8]邓先锐,徐国宏,岳文杰,等.保留胃窦空肠间置双通道手术与传统消化道重建对胃食管结合部癌患者生存质量及预后的影响对比[J].河北医学,2015,21(8):1423-1426.
[9]邹贵军,胡时栋,王迪,等.全腹腔镜远端胃癌根治术后消化道重建方式的对比[J].腹腔镜外科杂志,2016,21(11):820-823.
[10]李伟学,曾涛.不同消化道重建方案在胃癌手术患者中的应用效果[J].安徽医药,2015,19(8):1569-1570.
[11]孙海滨,田永静,宝音升博尔,等.间置空肠术与两种常见消化道重建方式对近端胃癌术后生活质量影响的对比研究[J].中国医药导报,2016,13(11):112-116.
[12]杨玉兵.全胃切除患者术后不同消化道重建方式对营养代谢的影响[J].重庆医学,2016,45(8):1077-1079.