毕Ⅱ式联合Braun吻合术在远端胃癌根治中的应用研究
The application of Billroth Ⅱ combined with Braun anastomosis in the radical resection of distal gastric cancer and the impact of patient immunity and intestinal barrier function
张龙飞 1童锋 1潘海华 1卫华松1
作者信息
- 1. 321100 兰溪,浙江省兰溪市人民医院
- 折叠
摘要
目的 探讨毕Ⅱ式联合Braun吻合术在远端胃癌根治中的应用及患者免疫、肠道屏障功能的影响.方法 回顾性选取 2019年 1 月至 2023 年 2 月本院收治的 56 例远端胃癌并行根治手术的患者的临床资料.所有患者均行远端胃癌根治术治疗,对照组 28例患者通过毕Ⅱ式吻合术重建消化道,观察组 28 例患者通过毕Ⅱ式联合Braun 吻合术重建消化道.比较两组患者的手术情况、免疫及屏障功能、炎症因子和术后的并发症情况.结果 两组患者的术后排气时间和术后住院时间比较差异不显著,P＞0.05;而观察组的手术时间和消化道重建时间显著高于观察组,差异具备统计学意义,P＜0.05.两组患者术前的补体C3、补体C4、降钙素原和D-乳酸水平比较差异不显著,P＞0.05;对照组患者术后的补体C3、补体C4 均显著高于对照组,P＜0.05;对照组术后的D-乳酸水平显著低于对照组,P＜0.05;术后的降钙素原比较差异不显著,P＞0.05.两组患者术前的IL-6 和IL-10 比较差异无统计学意义,P＞0.05;而观察组术后的IL-6和IL-10显著低于对照组,P＜0.05.两组患者术后的不良反应的发生的比较差异无统计学意义,P＞0.05.结论 毕Ⅱ式联合Braun吻合术在远端胃癌根治中能够减少对患者术后的免疫和肠道屏障的影响,减轻术后的炎症反应,安全可靠.
Abstract
Objective To investigate the application of Billroth Ⅱ combined with Braun anastomosis in the radical distal gastrectomy for gas-tric cancer and the impact of patient immunity and intestinal barrier function.Methods Clinical data of 56 patients with distal gastric cancer un-dergoing radical surgery admitted to our hospital from January 2019 to February 2023 were retrospectively selected.All patients underwent distal gas-trectomy for gastric cancer.The control group consisted of 28 patients who underwent Billroth Ⅱ anastomosis to reconstruct the digestive tract,while the observation group consisted of 28 patients who underwent Billroth Ⅱ combined with Braun anastomosis to reconstruct the digestive tract.The sur-gical conditions,immune and barrier functions,inflammatory factors,and postoperative complications were compared between the two groups.Re-sults There was no significant difference in the postoperative period time,and postoperative hospitalization time between the two groups(P>0.05).The surgical time and digestive tract reconstruction time in the observation group were significantly higher than those in the observation group,with statistically significant differences(P<0.05).There was no significant difference in preoperative levels of complement C3,complement C4,procalci-tonin,and D-lactate between the two groups of patients(P>0.05).The postoperative levels of complement C3 and complement C4 in the control group were significantly higher than those in the control group(P<0.05).The postoperative D-lactate level in the control group was significantly lower than that in the control group(P<0.05).The difference in postoperative procalcitonin levels was not significant(P>0.05).There was no significant difference in preoperative IL-6 and IL-10 between the two groups(P>0.05).The postoperative IL-6 and IL-10 levels in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the occurrence of postoperative adverse reactions between the two groups(P>0.05).Conclusion Billroth Ⅱ combined with Braun anastomosis can reduce the impact on postoperative immunity and intestinal barrier in patients with distal gastric cancer radical resection,reduce postoperative inflammatory response.
关键词
胃癌/毕Ⅱ式吻合/腹腔镜/Braun吻合/免疫/肠道屏障Key words
Gastric cancer/Billroth type Ⅱ anastomosis/Laparoscopy/Braun anastomosis/Immunization/Intestinal barrier引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据