早期远端胃癌行胃部分切除术中保留迷走神经的临床疗效分析

目的 探讨早期远端胃癌采取保留迷走神经的胃部分切除术的临床疗效.方法 选取73例早期远端胃癌患者,随机分为观察组(38例)和对照组(35例).观察组采取保留迷走神经的胃部分切除术,对照组采用常规胃部分切除术.比较2组患者术后的生活质量、营养状况、复发率和3年生存率以及胃排空功能和胆囊收缩功能恢复情况.结果 2组的复发率和3年生存率比较无统计学差异.观察组患者的吞咽困难、胃部疼痛、呃逆、饮食受限、焦虑和口干等生活质量指标评分均低于对照组,总分亦低于对照组;味觉的变化和头发脱落现象2组比较无统计学差异.观察组患者术后血清总蛋白、血清白蛋白、血红蛋白等营养状况指标水平和BMI值均高于对照组.观察组患者的胃排空功能优于对照组,胆囊收缩功能仅在60 min时明显高于对照组.结论 保留迷走神经的胃部分切除术治疗早期远端胃癌可提高患者术后的生活质量和营养状况,胃排空功能和胆囊收缩功能恢复情况较好,但对复发率和3年生存率无明显改善.

Analysis of Clinical Efficacy of Vagus Nerve Preserving Partial Gastrectomy in the Treatment of Early Distal Gastric Cancer

Objective To explore the clinical efficacy of vagus nerve preserving partial gastrectomy for early distal gas -tric cancer.Methods 73 cases of early distal gastric cancer were chosen and randomly divided into the observation group (38 cases) and the control group (35 cases).The observation group received vagus nerve preserving partial gastrectomy ,while the control group was treated with normal gastric resection .Life quality,nutritional status,recurrence rate,and 3-year survival rate, gastric emptying function and gallbladder contraction function recovery of the 2 groups after surgery were compared .Results The recurrence rates and 3-year survival rates of the 2 groups had no significant difference .The quality of life scores of the observation group,such as dysphagia,pain in the stomach,hiccups,limited diet,anxiety and dry mouth were lower than the control group ,so as to the total score .The difference in taste and hair loss of the 2 groups were not statistical .The serum total protein ,serum albu-min,hemoglobin level ,nutritional status indicators and BMI of the observation group after surgery were higher than the control group.Gastric emptying function of the observation group was better than that of the control group ,and the gallbladder contraction function was significantly higher than the control group only after 60 min.Conclusion Vagus nerve preserving partial gastrecto-my for early distal gastric cancer patients can improve the quality of life and nutritional status after surgery ,which also enhance the recovery of gastric emptying function and the gallbladder contraction function .But the recurrence rate and 3-year survival rate have no obvious improvement after operation .