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目的探讨胃十二指肠三角吻合术在远端胃癌根治术后消化道重建中的安全性及效果。方法选取2015年1月至2015年12月本院收治的204例胃癌患者,根据随机数字表法将患者随机分为观察组和对照组,观察组100例,予以全腹腔镜下远端胃癌根治胃十二指肠三角吻合术,对照组104例,予以腹腔镜BillrothⅠ吻合术,比较两组患者的术中出血量、手术时间、淋巴结清扫数量、首次肛门排气时间、恢复饮水时间、流质饮食时间、术后住院时间;随访6个月,比较两组患者的血液营养学指标及并发症发生率。结果观察组患者术中出血量显著少于对照组,手术时间显著短于对照组(P<0.05)。观察组及对照组的淋巴结清扫数量比较,差异无统计学意义(P>0.05)。观察组患者首次肛门排气时间、恢复饮水时间、恢复流质饮食时间、术后住院时间均显著短于对照组(P<0.05)。随访6个月,观察组血红蛋白、前白蛋白、血浆总蛋白水平均显著高于对照组(P<0.05)。观察组术后总并发症发生率为8%(8/100),对照组术后总并发症发生率为9.62%(10/104),经χ~2检验,两组术后并发症发生率比较无显著差异(χ~2=0.743,P=0.102)。结论胃十二指肠三角吻合术具有出血少、创伤小、恢复快等优点,可有效促进远端胃癌根治术后患者营养状况的恢复,减少术后并发症,是胃癌患者比较理想的消化道重建手术方法。
Objective To investigate the safety and efficacy of gastroduodenal anastomosis in the digestive tract reconstruction after radical gastrectomy for distal gastric cancer. Methods Totally 204 patients with gastric cancer admitted to our hospital from January 2015 to December 2015 were randomly divided into observation group and control group according to random number table method. The observation group received 100 cases of complete radical laparoscopic distal gastric cancer Gastro-duodenal triangle anastomosis, the control group of 104 cases, to be laparoscopic Billroth Ⅰ anastomosis, the two groups of patients were compared intraoperative blood loss, operative time, the number of lymph node dissection, the first time of anal exhaust, to restore drinking time, liquid diet Time, postoperative hospital stay; follow-up of 6 months, comparing the two groups of patients with blood nutritional indicators and the incidence of complications. Results The observation group had significantly less intraoperative blood loss than the control group, and the operation time was significantly shorter than that of the control group (P <0.05). The number of lymph node dissection in the observation group and the control group was no significant difference (P> 0.05). In the observation group, the time of the first anus discharge, the recovery of drinking time, the recovery of the fluid diet and the postoperative hospital stay were significantly shorter than those of the control group (P <0.05). After 6 months of follow-up, the hemoglobin, prealbumin and total plasma protein in the observation group were significantly higher than those in the control group (P <0.05). The incidence of postoperative complications was 8% (8/100) in the observation group and 9.62% (10/104) in the control group. The incidence of postoperative complications There was no significant difference (χ ~ 2 = 0.743, P = 0.102). Conclusions Gastric-duodenal anastomosis has the advantages of less bleeding, less trauma and faster recovery, which can effectively promote the recovery of nutritional status of patients after radical gastrectomy and reduce postoperative complications. It is an ideal gastrointestinal tract for patients with gastric cancer Reconstruction of surgical methods.