全胃切除后单腔空肠间置代胃术疗效分析

目的探讨全胃切除术后采用40cm长度的顺行性间置空肠代胃术重建消化道的临床效果.方法对39例行间置空肠代胃术患者随访一年,观察其代胃的储存量、排空时间、反流情况、进食量、体能恢复、临床症状、体重及血浆营养参数(血红蛋白、血浆总蛋白).结果术后二周时一次吞服钡剂量为120ml(100～150),代胃排空时间平均40分钟(20～90),未见钡剂反流入食道,无间置肠段梗阻,术后一年时进食米量2～3两/餐,进餐次数为3～4次/日,无倾倒综合症,均可以从事轻～中度的体力活动.入院时与术后一年的血浆营养参数与体重比较有明显差异.(P＜0.01)结论采用40cm长度的顺行性间置空肠代胃术操作简便,临床效果良好.

The clinical effect of single-canal jejunum interposition after total gastrectomy

Object to evaluate tha clinical effect of 40cm anterograde single-canal jejunum interposition graft as gastric replacement in alimentary reconstruction after total gastrectomy for the gastric carcinoma. Methods clinical follow-up 1 year, excluding the recurrence and metastasis. Vaious monitorings including storage volume of the gastric replacement, emptying time, reflux to esophagus, daily food intake quality of life, clinical symptoms, body weight gain and plasma nutritional parame er (homoglobin and total protein) were used on 39 cases after such reconstruction. Result 2 week after operation, the amount of consumed barium meal averaged 120ml (100-150) per time and the mean emptying time was 40 minutes (20-90). None had barium reflux, jejunum interposition obstruction and dumping syndrome. one year after operation, the food intake(rice) was 100-150g per times and 3-4 times a day. All the patients undertook light ormedium work. There were significant differences in plasma mutritional parameter and body weight gain of patients between the first hospitalized phase and one year after operation (P<0.01). Conclusion Anterograde single-canal jejunum interposition graft as gastric repalacement is a better surgical method.