摘要
目的:对比在近端胃切除术后应用不同抗反流消化道重建技术的临床效果。方法:回顾性分析2020年1月至2022年12月行近端胃切除术并于术后接受抗反流消化道重建术的83例胃癌患者临床资料，依据抗反流消化道重建方式分为程氏组（接受食管-胃“程氏Giraffe重建术”，n=36例）与间置空肠组（接受间置空肠吻合术，n=47例）。采用SPSS 25.0软件处理数据，围手术期指标、胃肠道症状评定量表（GSRS）评分和术后6个月营养状况等计量资料以（）表示，组间比较用独立样本t检验；术后远期并发症等计数资料用χ2检验。P<0.05为差异有统计学意义。结果:程氏组患者术后住院时间短于间置空肠组，差异有统计学意义（P<0.05）；术后6个月，程氏组患者血红蛋白、白蛋白及体重增加量均大于间置空肠组，差异均有统计学意义（P<0.05）；两组患者远期并发症总发生率对比，差异无统计学意义（P>0.05）；与术前相比，术后6个月两组患者GSRS评分均下降，且程氏组患者显著低于间置空肠组，差异有统计学意义（P<0.05）。结论:与间置空肠吻合术相比，在近端胃切除术后采用食管-胃“程氏Giraffe重建术”可明显缩短胃癌患者术后住院时间，改善其营养状况并减轻胃肠道症状。
Abstract
Objective:To compare the clinical effects of different anti-reflux digestive tract reconstruction techniques after proximal gastrectomy.Methods:Clinical data of 83 patients with gastric cancer who underwent proximal gastrectomy and underwent postoperative anti-reflux digestive reconstruction from January 2020 to December 2022 were retrospectively analyzed. According to the methods of anti-reflux digestive reconstruction, they were divided into Cheng group (receiving esophagogastric "Cheng Giraffe reconstruction", n=36 cases) and interposition jejunal group (receiving interposition jejunostomy, n=47 cases). SPSS 25.0 software was used to process the data. Perioperative indicators, gastrointestinal symptom Rating Scale (GSRS) score and nutritional status 6 months after surgery were expressed as () . Independent sample t test was used for comparison between groups. The long term complications were measured by χ2 test. P < 0.05 was considered statistically significant.Results:The length of hospital stay in Cheng's group was shorter than that in interposition jejunum group, and the difference was statistically significant (P < 0.05). Six months after surgery, the increase of hemoglobin, albumin and body weight in Cheng's group was higher than that in interposition jejunum group, the differences were statistically significant (P < 0.05). There was no significant difference in the total incidence of long-term complications between the two groups (P > 0.05). Compared with pre-operation, GSRS scores in both groups decreased 6 months after surgery, and Cheng's group was significantly lower than interposition jejunum group, with statistical significance (P < 0.05).Conclusion:Compared with interposition jejunostomy, the use of esophagogastric Giraffe reconstruction after proximal gastrectomy can significantly shorten postoperative hospital stay, improve nutritional status and alleviate gastrointestinal symptoms in patients with gastric cancer.
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