目的 评价国产吻合器和闭合器在食管癌消化道重建术中的应用价值。 方法 回顾性分析2005年3月-2008年4月期间收治的387例食管癌手术患者的临床资料,根据不同消化道重建方式分为手工吻合组(n=172)和器械吻合组(n=215),对两组患者吻合时间、术中出血量及术后并发症发生情况进行对比分析。 结果 全组无手术死亡。器械吻合组和手工吻合组术中出血量的差别无统计学意义(Pgt;0.05),但前者的吻合时间、住院时间均少于后者(Plt;0.05)。手工吻合组术后吻合口出血多于器械吻合组(5.2%比1.4%,Plt;0.05),发生吻合口漏亦多于器械吻合组(6.4%比2.8%,Plt;0.05)。随访1.5~2年,排除失访患者后,器械吻合组吻合口狭窄发生率低于手工吻合组(4.6%比10.3%,Plt;0.05)。 结论 国产吻合器与和缝合器用于食管癌的消化道重建安全有效,值得在基层医院推广应用。
Objective To investigate for a reasonable reconstruction method in patients undergoing total gastrectomy. Methods Data of 63 cases receiving total gastrectomy from January 2000 to October 2005 in Ganzhou District Hospital of Zhangye City were analyzed retrospectively, and the patients were divided into double pouch jejunum interposition (DPJI) group (n=30) and Roux-en-Y ρ pouch (RYρ) group (n=33) according to the operation methods, then operation time, morbidity of complications, amount and frequency of meat and drink, complications of digestive tract, amount of total protein and albumin were compared between two groups. Results There were no significant differences in operation time,morbidity of complications, the amount or frequency of meat and drink between two groups (Pgt;0.05); but the incidence of digestive tract complications of DPJI group was lower than that of RYρ group (P<0.05). GradeⅠ/Ⅱof Vervaeck index and the amount of total protein and albumin in DPJI group were statistical significantly higher than those of RYρ group (P<0.05). Conclusion Functional DPJI is a reasonable digestive tract reconstruction method.