腹腔镜胃旁路术结肠前与结肠后胃空肠吻合术前瞻性44例比较研究.docVIP

腹腔镜胃旁路术结肠前与结肠后胃空肠吻合术前瞻性44例比较研究 　　[摘要] 目的 对腹腔镜胃旁路术结肠前与结肠后胃空肠吻合术的前瞻性44例进行比较研究。 方法 整群选取该院2011年4月―2015年4月收治的肥胖症患者88例，并按照随机分配法则将其分配成两组进行回顾性研究，观察组44例患者接受结肠前胃空肠吻合术；对照组44例患者接受结肠后胃空肠吻合术治疗，系统观察两组患者手术时长、出血量、排气时间、住院时间等以及各种术后并发症的发生情况。 结果 上述88例患者经过手术治疗后病情均得到明显缓解，经比较发现，观察组患者的手术时长、术中失血量、排气时间、住院时间均明显较试验对照组少，差异有统计学意义（P0.05）。 结论 经试验比较发现，腹腔镜胃旁路结肠前胃空肠吻合术较结肠后吻合术操作更容易，难度系数更小，手术用时较短，但并发症的发生率略高于结肠后吻合术，但均无严重并发症如腹内疝等发生，建议推广前者。 　　[关键词] 腹腔镜；胃旁路术；结肠前胃空肠吻合；结肠后胃空肠吻合 　　[中图分类号] R473.6 [文献标识码] A [文章编号] 1674-0742（2015）09（b）-0068-02 　　[Abstract] Objective To compare the efficacy of antecolic versus retrocolic gastroenteric anastomosis for laparoscopic gastric bypass with 44 cases in each group through a prospective randomized control trial. Methods 88 obese patients admitted to our hospital between April 2011 and April 2015 were randomized into two groups for a retrospective study， 44 of whom experienced antecolic gastroenteric anastomosis， while the other 44 underwent retrocolic gastroenteric anastomosis. The operation duration， intraoperative blood loss， exhaust time， lengthy of hospital stay， as well as the complication were systematically observed. Results After treatment， all the 88 patients obtained improvement in disease， and comparison showed that the operation duration， intraoperative blood loss， exhaust time， lengthy of hospital stay were all less in the observation group than in the control group， and the differences were statistically significant， P0. 05）. Conclusion Comparison in this study shows that antecolic gastroenteric anastomosis is easier and quicker in operation， but has more complications than retrocolic gastroenteric anastomosis， what’s more， it shows no serious complications such as abdominal hernia， therefore it is worthy of promotion. 　　[Key words] Laparoscopy； Gastric bypass； Antecolic gastroenteric anastomosis； Retrocolic gastroenteric anastomosis 　　在我国，应用腹腔镜胃旁路术（LaparoscopicRoux-en-Y gastric bypass）对2型糖尿病以及肥胖症进行治疗的技术以及发展到一定的高度，其发展应用给临床和患者均带来了福音[1]。目前，国内临床范围对手术操作譬如结肠