摘要
目的 探讨胃癌全胃切除术后Lahey法、Lawrence法及袢式空肠代胃改良Ⅱ式消化道重建术对患者营养状态及消化道症状的影响。方法 回顾性分析178例胃癌行全胃切除术的患者．其中以Lahey法重建消化道者83例，以Lawrence法重建消化道者63例，以袢式空肠代胃改良Ⅱ式者32例，重点比较术后6个月时患者营养状态及消化道症状。结果 术后6个月时袢式空肠代胃改良Ⅱ式组及Lawrence组体重下降程度显著低于Lahey组，P〈0．001；血浆总蛋白、白蛋白水平变化，改良Ⅱ式组及Lawrence组分别升高，而Lahey组降低，差异显著，P值分别为P〈0．05及P〈0．005。术后6个月时消化道症状，进食次数3～5次者改良Ⅱ式组低于Lahey组而Lawrence组高于Lahey组，P〈0．05；大于5次者改良Ⅱ式组高于Lahey组，P〈0．05；而Lawrence组低于Lahey组，P〉0．05。呕吐者改良Ⅱ式组4例（7．1％）和Lawrence组6例（13％）显著低于Lahey组14例（46．7％），P〈0．05；心窝部烧灼感者Lawrence组4例（8．7％）、改良Ⅱ式组6例（10．7％）低于Lahey组10例（33．3％）但无显著性差异。结论 袢式空肠代胃改良Ⅱ式及Lawrence法消化道重建术是胃癌全胃切除术后较为理想的一种消化道重建方式，使全胃切除术后患者生存质量提高。
Objective To discuss the different surgical reconstruction procedures which is better for improving the life quality, the nutritional status and dige.stive tract symptoms of postoperative gastric cancer patients who have cucepced.Methods As a retrospective analysis, we collected 178 cases following the total gastrectomy. Among them, 83,63 and 32 cases had been performed Lahey, Lawrence and revised Lahey type Ⅱ digestive tract reconstruction procedures respectively. We focused on the nutritional status changing and digestive symptoms merging at 6th month postoperatively. Results At the timepoint-6th month post operation, weight loss ratio in other groups was significantly less than that in the Lahey group （ P 〈 0.001 ）. And the total protein level and albumin level in circulation in Lawrence group and revised Lahey type Ⅱ group were significantly higher than that in the Lahey group （ P 〈 0.05 and P 〈 0.005 respectively）. Patients with vomiting in revised Lahey typeⅡ group （4 cases,7.1%） and in Lawrence group （6 cases,13%） were obviously lower than that in the Lahey group （14 cases,46.7%）,all the P value were less than 0.05.The nausea symptom seemed no difference among above three groups. Conclusion The revised Lahey type Ⅱ and Lawrence protocols are much better surgical reconstructions procedures following total gastrectomy. Compared with Lahey procedure, these procedures benefit patients by improving their life quality.
出处
《哈尔滨医科大学学报》
CAS
北大核心
2007年第6期593-595,共3页
Journal of Harbin Medical University
关键词
胃癌
全胃切除术
消化道重建术
gastric carcinoma
total gastrectomy
digestive tract reconstruction procedure
