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目的探讨贲门癌胸腹联合切除术后合理的消化道重建方法及对术后生活质量的影响。方法回顾性分析食管残胃间空肠间置组(重建组)16例和食管残胃吻合组(对照组)的贲门癌患者18例,分别观察术后1个月、3个月、6个月、9个月、12个月反流性食管炎发生情况及体重变化情况。结果两组患者术后1个月、3个月、6个月、9个月、12个月烧心、反流严重程度评分重建组明显低于对照组,两组比较差异有显著性,P<0.05;两组患者术后3个月、6个月、9个月体重变化情况评分,重建组明显低于对照组,两组比较差异有显著性,P<0.05。结论空肠间置术手术时间相对延长,术后并发症并未增加,术后烧心、反流症状减轻,生活质量明显改善,体重及营养恢复较快,是胸腹联合Ⅱ型贲门癌根治术后较合理的消化道重建方法。
Objective To investigate the reasonable methods of digestive tract reconstruction after thoracoabdominal and abdominal resection of cardia cancer and its influence on postoperative quality of life. Methods A retrospective analysis of 18 cases of cardia cancer patients in esophageal and gastric residual group (reconstruction group) and esophagogastric anastomosis group (control group) were retrospectively analyzed. One month, three months, six months , 9 months, 12 months reflux esophagitis incidence and weight changes. Results The two groups of patients after 1 month, 3 months, 6 months, 9 months and 12 months postoperative heartburn, severity of reflux score reconstruction group was significantly lower than the control group, the difference between the two groups was significant, P < 0.05; The two groups of patients after 3 months, 6 months, 9 months weight changes score, reconstruction group was significantly lower than the control group, the difference between the two groups was significant, P <0.05. Conclusions The operation time of jejunostomy is relatively longer, the postoperative complications are not increased, the symptoms of postoperative heartburn and reflux are relieved, the quality of life is improved obviously, and the weight and nutrition are recovered quickly. More reasonable method of digestive tract reconstruction.