近端胃癌根治性切除术后两种重建术式的评价.docVIP

近端胃癌根治性切除术后两种重建术式的评价 　　【摘要】 目的：探讨不同近端胃癌根治性切除手术与重建术式的疗效与生存状况。方法：选取2014年 　　1月-2015年1月在本院接受近端胃癌根治性切除手术的患者80例，按随机数表法分为试验组与对照组，每组各40例，其中对照组近端胃癌行近端胃切除和全胃切除，试验组行近端胃切除间置空肠代胃术，对比术后1个月两组患者SF-36（简明生活质量评分），记录术后1个月内两组患者的营养水平及术后1周内的不良反应状况。结果：术后1个月SF-36评分中总体健康和生命活力得分对照组分别为（35.3±2.2）分、（37.8±1.3）分，试验组分别为（46.2±1.4）分、（49.8±2.1）分，两组患者的生存质量评分比较差异均有统计学意义（P0.05）。对照组较术前血红蛋白变化率、体质量变化率分别为（-6.5±0.5）%、（-11.3±0.4）%，试验组分别为（-3.9±0.3）%，（-7.2±0.2）%，两组的营养水平比较差异均统计学意义（P0.05）。对照组术后发生恶心呕吐、食欲下降以及腹泻的不良反应率为12.5%、15.0%、17.5%，试验组分别为5.0%、2.5%、7.5%，两组不良反应比较差异均有统计学意义（P0.05）。结论：间置空肠代胃术较近端胃癌行近端胃切除和全胃切除术可以显著地提高患者的生存质量，改善患者的营养状况降低患者术后的不良反应。 　　【关键词】 近端胃癌； 重建术； 疗效； 生存状况 　　【Abstract】 Objective：To investigate the curative effect and the survival of different proximal gastric cancer radical resection and reconstruction.Method： From January 2014 to January 2015，80 patients with proximal gastrectomy for gastric cancer were selected in our hospital.By random number table methods，they were divided into experimental group and control group，40 cases in each group.The control group received total gastrectomy and proximal stomach cancer proximal gastrectomy，and the experimental group was treated with proximal gastrectomy for gastric resection.The SF-36 （concise quality of life score） postoperative 1 months，trophic levels after 1 month and adverse reactions within one week after operation of two groups were compared and recorded.Result：Postoperative 1 month， SF-36 scores in general health and vitality scores of control group were respectively （35.3±2.2） scores and （37.8±1.3） scores，experimental group of those were respectively （46.2±1.4） scores and （49.8±2.1） scores，the differences were statistically significant（P0.05）.The preoperative hemoglobin change rate and body mass rate in control group were respectively（-6.5±0.5）% and （-11.3±0.4）%，experimental group of those were respectively （-3.9±0.3）% and （-7.2±0.2）%，nutrition levels of two groups had significant difference（P0.05）.The adverse reaction rate of postoperative nause