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目的研究将间置空肠法应用到全胃切除患者的消化道重建中对患者早期营养的影响。方法 70例行择期全胃切除手术的患者按照全胃切除后消化道重建方式不同分为观察组和对照组,每组35例。观察组使用间置空肠法,对照组使用Roux-en-Y吻合法。对比两组患者术前术后营养状况、代胃消化道储物功能、Visick分级。结果术后,两组患者营养状况均得到明显改善,观察组白蛋白、总蛋白、血红蛋白及体重均较对照组高,差异均具有统计学意义(P<0.05);观察组患者代胃肠管内钡剂可储留时间(57.82±24.31)min,明显长于对照组的(15.69±8.20)min,差异具有统计学意义(P<0.05);观察组代胃肠管最大直径较对照组长,观察组患者反流性食管炎发生率较对照组低,差异均具有统计学意义(P<0.05);观察组患者Visick分级优于对照组,差异具有统计学意义(P<0.05)。结论使用间置空肠法进行全胃切除后消化道重建,可显著改善患者的早期营养状况,肠道功能紊乱发生较少,是理想的消化道重建术。
Objective To study the effect of intercostal jejunal method on early nutrition in patients with gastrectomy during digestive tract reconstruction. Methods Seventy patients undergoing elective total gastrectomy were divided into observation group and control group according to different ways of total gastrectomy digestive tract reconstruction, with 35 cases in each group. In the observation group, the indirect jejunal method was used and in the control group Roux-en-Y was used. Preoperative and postoperative nutritional status of the two groups were compared, the gastric alimentary canal storage function and Visick grading were compared. Results After operation, the nutritional status of both groups were significantly improved. The levels of albumin, total protein, hemoglobin and body weight in the observation group were significantly higher than those in the control group (P <0.05). In the observation group, the gastrointestinal (57.82 ± 24.31) min, which was significantly longer than that of the control group (15.69 ± 8.20) min, the difference was statistically significant (P <0.05). The maximum diameter of gastrointestinal tube in the observation group was longer than that of the control group The incidence of reflux esophagitis was lower in the control group than in the control group (P <0.05). The Visick classification in the observation group was better than that in the control group (P <0.05). Conclusion The method of indirect jejunal gastrectomy for digestive tract reconstruction can significantly improve the early nutritional status of patients with less intestinal dysfunction and is an ideal method for digestive reconstruction.