全胃切除术后2种消化道重建术式患者消化道动力的变化分析

目的 对比分析全胃切除术后行食管空肠Roux-Y吻合术和单腔空肠间置术患者消化道动力的变化。方法 选取2010年1月至2011年6月辛集市第一医院行全胃切除术的126例患者作为研究对象，患者生存期均达6个月，根据全胃切除术后消化道重建方式分为观察组（n=63例）与对照组（n=63例），另外设63例健康人作为健康组。对照组全胃切除术后给予单腔空肠间置术，观察组全胃切除术后给予食管空肠Roux-Y吻合术，健康组不施加干预措施。结果 观察组患者的体质量、每日进餐次数、每日进食量均低于对照组，差异有统计学意义（P<0.05），两组均低于健康组，差异有统计学意义（P<0.05）。观察组患者出现上腹饱胀、倾倒综合征、嗳气的发生率明显高于对照组，差异有统计学意义（P<0.05）。结论 Roux-Y吻合术法营养状况的改善情况差于单腔空肠间置术，术后不适症状较多，应根据患者的具体情况选择重建方法，如果患者体质允许应以单腔空肠间置术作为首选。

Changes of esophageal jejunal Roux-Y anastomosis and single lumen jejunal interposition after total gastrectomy in patients with gastrointestinal motility

Objective To investigate the gastric resection of esophagus jejunum Roux-Y jejunum anastomosis and single cavity between surgery in patients with gastrointestinal dynamic change.Methods Selected from January 2010 to June 2011, during our whole gastrectomy patient surial for six months of 126 as the research object, accorded the construction techniques after radical total gastrectomy,the patients were divided into two groups:observation group (63 cases) and control group (63 cases), another 63 cases of healthy people were health group. Control group were given single cavity between the jejunum surgery, observation group lines of esophagus jejunum Roux-Y anastomosis, healthy group do not exert pressure.Results Observation group''s weight, number of daily meals, the daily food intake were less than the control group (P<0.05), the two groups indexes were less than healthy group (P<0.05). The incidence of observation group of abdominal distension, belching, dumping syndrome, belching incidence were significantly higher than the control group, the difference was statistically significant (P<0.05).Conclusion Roux-Y anastomosis method on the improvement of their nutritional status is not inferior to single cavity between the jejunum surgery, but the postoperative symptoms is more, therefore should choose according to the specific condition of patients with appropriate methods of revascularization,but should be in a single cavity between the jejunum surgery as the preferred method.