非离断RouxenY储袋法在全胃切除术中的研究
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【摘要】 目的 探讨非离断式RouxenY空肠储袋消化道重建法在全胃切除术中的临床研究及应用意义。方法 将60例胃癌全胃切除手术患者按入院顺序简单随机化法分为对照组30例(常规RouxenY消化道重建)、观察组30例(非离断RouxenY 储袋法消化道重建),对照两组消化道重建时间、术后半年反流性食管炎、倾倒综合征发生率、体重增加、血红蛋白、血清总蛋白、血清蛋白水平。结果 两组消化道重建时间、术后半年体重增加、血红蛋白、血清总蛋白、血清蛋白水平比较分别(t=4.55、4.66、5.67、5.64、6.12，P<0.05)。结论 全胃切除术应用非离断式RouxenY空肠储袋消化道重建法操作简便可行，能降低术后并发症和提高生活质量，是全胃切除术较理想的消化道重建术式。
【关键词】 非离断；RouxenY；储袋法；研究
Non isolated RouxenY storage bag method in total gastrectomy in research CHEN Yongbuo. Shandong Huafeng Coal Mine of Xinwen Mining Group Two Branch Hospital,Shandong 271413,China
【Abstract】 Objective to investigate the non breaking type RouxenY jejunal reservoir bag methods of reconstruction of digestive tract after total gastrectomy clinical research and application. Methods 60 cases of total gastrectomy for gastric cancer operation patients in hospital order simple randomization method was divided into30 cases of the control group (conventional RouxenY reconstruction of the digestive tract), the observation group 30 cases (non isolated RouxenY storage bag method in digestive tract reconstruction), control group two reconstruction of digestive tract after half a year of time, reflux esophagitis, dumping syndrome incidence, increased body weight, hemoglobin, serum total protein, serum protein level. Results Two groups of digestive tract reconstruction time, after half a year to gain weight, hemoglobin, serum total protein, serum protein level comparison respectively (t=4.55,4.66,5.67,5.64,6.12, P< 0.05),after half a year to reflux esophagitis, dumping syndrome incidence rate (χ2= 4.33,4.56, P
【Key words】 Non amputated; RouxenY; Storage bag method; Research
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作者单位：271413 山东省新汶矿业集团华丰煤矿医院外二科 胃癌是我国常见的恶性肿瘤，常采用全胃切除、肠道重建手术治疗[1], 虽然根治性全胃切除是目前治疗胃恶性肿瘤的重要手段，但是患者术后常面临着胃容积的丧失，消化液减少、终致严重营养不良[2]。所以，中外学者设计了许多消化道重建术式以改善营养、提高患者生活质量[3]。但目前对于因恶性肿瘤而行全胃切除术后满意的消化道重建方式尚无定论[4]。经典的RouxenY吻合为全胃切除后最常用之重建术式，已为大多数医生所接受，但仍可频频出现营养状况和生活质量的问题[5]，为此，尝试应用一种新的非离断RouxenY储袋法[6] ......
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