直线切割闭合器行幽门成形术在近端胃切除术后的临床疗效

发布时间：2018-05-24 08:01

本文选题：幽门成形术 + 近端胃切除术　；参考：《重庆医科大学》2015年硕士论文

【摘要】：目的：探讨使用直线切割闭合器行幽门成形术在贲门胃底部占位性病变行近端胃切除术后的临床疗效。方法：选取2010.01-2013.12期间我科收治近端胃占位性病变患者共计94例,其中实验组(A组)54例,其中28例胃底贲门癌病例均行近端胃癌根治性切除(D2),26例良性占位性病变病例行近端胃切除,所有病例在上述操作基础上均使用直线切割闭合器行幽门成形术。对照组(B组)40例,胃底贲门癌22例、良性占位性病变18例,手术处理原则上均同实验组(A组),但不附加幽门成形术。结果：两组患者一般资料情况差异无统计学意义(P0.05)；实验组(A组)患者术后胃管留置时间、胃管引流量、肠道功能恢复时间、平均住院时间,远期并发症,如：术后3月患者出现餐后饱胀不适、反酸、胸骨后烧灼感等反流性食管炎临床表现的发生率、胃镜提示反流性食管炎、幽门狭窄的发生率较对照组(B组)差异有统计学意义(P0.05)；两组患者胃瘫发生率无显著性差异(P0.05)。结论：在近端胃切除术中使用直线切割闭合器进行幽门成形术可减少胃潴留及反流性食管炎的发生,减少住院时间,有利于患者术后恢复,适合临床推广应用。
[Abstract]:Objective: to investigate the clinical effect of pyloroplasty with linear cutting closure in proximal gastrectomy of gastric cardia. Methods: a total of 94 patients with proximal gastric space occupying lesions were treated in our department during 2010.01-2013.12, including 54 cases in group A, 28 cases of gastric fundus cardia carcinoma were treated with radical resection of proximal gastric carcinoma and 26 cases of benign space occupying lesions were treated with proximal gastrectomy. All patients underwent pyloroplasty using a linear cut-closure device on the basis of the above procedures. There were 40 cases of gastric fundus cardia carcinoma, 22 cases of gastric fundus cardia carcinoma and 18 cases of benign space occupying lesion in control group B. The surgical treatment was in principle the same as that in group A, but no pyloroplasty was added. Results: there was no significant difference in general data between the two groups (P 0.05, group A). The time of gastric tube indwelling, the drainage of gastric tube, the recovery time of intestinal function, the average time of hospitalization and the long-term complications were observed in group A (group A), group A (group A). For example, the incidence of postprandial fullness and discomfort, acid reflux, poststernal burning and other clinical manifestations of reflux esophagitis were observed 3 months after operation, and gastroscopy indicated reflux esophagitis. The incidence of pyloric stenosis was significantly higher than that of control group B (P 0.05), and there was no significant difference in the incidence of gastroparesis between the two groups. Conclusion: pyloroplasty with linear incision closure in proximal gastrectomy can reduce gastric retention and reflux esophagitis, reduce hospitalization time, and be suitable for clinical application.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.2

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