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目的探讨BillrothⅡ式远端胃切除术伴布朗式吻合术治疗胃癌的临床效果。方法选取2014年1月至2015年1月间于四川医科大学附属中医院行远端胃切除术的48例患者,根据手术治疗方法的不同,将其分为观察组(24例)和对照组(24例)。观察组患者行BillrothⅡ式远端胃切除术伴布朗式吻合术治疗,对照组患者单独行BillrothⅡ式远端胃切除术治疗,比较两组患者术后并发症发生情况。结果观察组患者无反流20例,轻度反流4例(16.7%),无重度反流患者,胆汁反流4例(16.7%)。对照组患者无反流0例,轻度反流11例(45.8%),重度返流13例(54.3%),胆汁24例(100.0%),组间各项差异均有统计学意义(P<0.05)。两组患者均未出现十二指肠残端破裂严重并发症。结论 BillrothⅡ式远端胃切除术伴布朗式吻合术治疗胃癌较单独应用远端胃切除术治疗更有效,可以显著减少胃癌患者术后碱性反流性胃炎的发生率。
Objective To investigate the clinical effect of Billroth Ⅱ distal gastrectomy with Brownian anastomosis in the treatment of gastric cancer. Methods Forty-eight patients undergoing distal gastrectomy from January 2014 to January 2015 in Sichuan Medical University Affiliated Hospital of Traditional Chinese Medicine were divided into the observation group (24 cases) and the control group according to the different surgical treatment methods (24 cases). Patients in the observation group were treated with Billroth type Ⅱ distal gastrectomy with Brownian anastomosis, and patients in the control group were treated with Billroth type Ⅱ distal gastrectomy alone. The postoperative complications were compared between the two groups. Results In the observation group, there were 20 cases without reflux, 4 cases with mild reflux (16.7%), 4 cases (16.7%) without reflux and 4 cases with bile reflux. The patients in the control group had no reflux, 11 (45.8%) had mild reflux, 13 (54.3%) had severe reflux, and 24 (100.0%) had bile. The differences among the groups were statistically significant (P <0.05). No serious complications of rupture of duodenal stump occurred in either group. Conclusion Billroth Ⅱ distal gastrectomy with Brownian anastomosis for the treatment of gastric cancer is more effective than the single distal gastrectomy alone, which can significantly reduce the incidence of postoperative alkaline reflux gastritis in patients with gastric cancer.