| 翟振鹏,张怀波,马荣龙.改良布朗式吻合术联合毕罗 Ⅱ吻合术在腹腔镜远端胃癌切除术 52例中的应用[J].安徽医药,2023,27(6):1140-1143. |
| 改良布朗式吻合术联合毕罗 Ⅱ吻合术在腹腔镜远端胃癌切除术 52例中的应用 |
| The application of modified braun anastomosis combined with billroth Ⅱ anastomosis in 52 cases of laparoscopic distal gastrectomy for gastric cancer |
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| DOI：10.3969/j.issn.1009-6469.2023.06.018 |
| 中文关键词: 胃切除术 腹腔镜检查 毕罗 Ⅱ吻合术 改良布朗式吻合术 胃肠功能恢复 营养指标 胃肿瘤 |
| 英文关键词: Gastrectomy Laparoscopy Billroth Ⅱ anastomosis Modified braun anastomosis Gastrointestinal function recovery Nutritional indicators Stomach neoplasms |
| 基金项目:河南省卫生健康委员会资助项目( LHGJ20191372) |
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| 中文摘要: |
| 目的研究改良布朗式吻合术联合毕罗 Ⅱ吻合术在腹腔镜远端胃癌切除术( LADG)病人中的应用效果。方法回顾性分析濮阳市油田总医院 2019年 5月至 2021年 3月收治的 103例 LADG病人的临床资料，根据病人病灶位置、大小及医师手术经验选择吻合术式，并按吻合方式的不同划分成毕罗 Ⅱ组和联合组。毕罗 Ⅱ组 51例实施毕罗 Ⅱ式吻合术，联合组 52例实施毕罗 Ⅱ式吻合术 +改良布朗式吻合术。比较两组手术情况、体质量、血红蛋白、白蛋白、术后并发症发生率及生活质量。结果联合组术后首次排气时间、进流食时间分别为( 2.3±0.6)d、(5.3±1.6)d，明显较毕罗 Ⅱ组的( 2.8±0.8)d、(6.5±2.1)d短(均 P<0.05)，手术用时、重建时间、术中失血量、淋巴结清扫数目、离床时间、术后住院时间和毕罗 Ⅱ组比较均差异无统计学意义( P>0.05)；联合组术后并发症发生率为 9.62%，明显较毕罗 Ⅱ组的 27.45%低( P<0.05)；术后 6个月两组体质量及血红蛋白、白蛋白水平和同组术前相比均明显降低(均 P<0.05)，但联合组术后体质量及血红蛋白、白蛋白水平分别为( 52.2±7.6)kg、(124.5±13.4)g/L、(34.4±2.3)g/L，明显较毕罗 Ⅱ组的( 49.4±6.3)kg、(113.7±12.9)g/L、(32.9±2.0)g/L高(均 P<0.05)；联合组术后 6个月胃肠道生活质量指数( GIQLI)为( 103.2±7.4)分，明显较毕罗 Ⅱ组的( 95.8±9.3)分高(P<0.05)。结论在 LADG中应用布朗式吻合术联合毕罗 Ⅱ吻合术，可明显加快术后胃肠功能恢复，显著减少对体质量、营养指标的影响，有效提高生活质量。 |
| 英文摘要: |
| Objective To study the effect of modified braun anastomosis combined with Billroth Ⅱ anastomosis in patients with laparoscopic distal gastrectomy (LADG).Methods The clinical data of 103 LADG patients admitted to Puyang Oilfield General Hospitalfrom May 2019 to March 2021 were retrospective analyzed. The anastomosis methods were selected according to the location, size andsurgical experience of the doctors, and they were divided into Billroth Ⅱ group and combined group according to the different anastomosis methods. Fifty-one patients in the Billroth Ⅱ group underwent Billroth Ⅱ anastomosis, and 52 patients in the combined groupunderwent Billroth Ⅱ anastomosis + modified braun anastomosis. The surgical status, body weight, hemoglobin, albumin, postoperative complications and quality of life were compared between the two groups.Results The first exhaust time and fluid diet intake time in the combined group were (2.3±0.6) d and (5.3±1.6) d, which were significantly shorter than (2.8±0.8) d and (6.5±2.1) d in the Billroth Ⅱ group (P<0.05), there was no significant difference in the operation time, reconstruction time, intraoperative blood loss, numberof lymph node dissections, time to get out of bed, and postoperative hospital stay between the combined group and the Billroth Ⅱgroup (P>0.05); the postoperative complication rate of the combined group was 9.62 %, which was significantly lower than 27.45% inthe Billroth Ⅱ group (P<0.05); at 6 months after operation, the body mass, hemoglobin and albumin, levels of the two groups were significantly lower than those of the same group before operation (P<0.05), but the body weight, Hb and albumin levels of the combinedgroup were (52.2±7.6) kg, (124.5±13.4) g/L and (34.4±2.3) g/L, which were significantly higher than (49.4±6.3) kg, (113.7±12.9) g/Land (32.9±2.0) g/L in the Billroth Ⅱgroup (P<0.05); the gastrointestinal quality of life index (GIQLI) of the combined group was (103.2±7.4) points,which was significantly higher than (95.8±9.3) points in the Billroth Ⅱ group at 6 months after the operation (P<0.05).Con? clusion The application of modified braun anastomosis combined with Billroth Ⅱ anastomosis in LADG can significantly acceleratethe recovery of gastrointestinal function after surgery, reduce the impacts on body weight and nutritional indicators, and effectively improve the quality of life. |
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