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目的评价食管部分切除贲门胃底重建术的临床效果及手术后生命质量。方法根据手术方式不同将226例食管癌患者分为两组,A组:食管胃黏膜吻合贲门胃底重建术172例,行食管部分切除,食管胃弓上黏膜吻合术加贲门胃底重建术;B组:全层围巾式吻合54例。均参照欧洲癌症研究与治疗组织(EORTC)QLQ-C 30和自制量表对患者术后3个月以上生命质量进行测评,并进行比较。结果回访率A组82.6%(142/172),B组77.8%(42/54)。A组在体力功能和情感功能维度得分高于B组(P<0.05),吞咽困难、胃食管反流症状方面得分低于B组(P<0.05)。结论食管胃黏膜弓上吻合贲门胃底重建术后患者体力功能和情感功能优于全层吻合组,吞咽困难、反流症状少于全层吻合术,生命质量高于全层吻合组。
Objective To evaluate the clinical effects and the quality of life after esophagectomy with gastric cardia reconstruction. Methods 226 cases of esophageal cancer patients were divided into two groups according to different surgical methods. Group A: esophageal and gastric mucosal anastomosis cardia fundus reconstruction in 172 cases, partial esophageal resection, esophageal and gastric mucosal anastomosis plus cardia fundic reconstruction; Group B: full-thickness scarf anastomosis in 54 cases. According to the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C 30 and self-made scales for patients over 3 months after the life quality assessment, and compared. Results The rate of return in group A was 82.6% (142/172), in group B 77.8% (42/54). The score of physical function and emotional function in group A was higher than that in group B (P <0.05), and the score of dysphagia and gastroesophageal reflux symptom in group A was lower than that in group B (P <0.05). Conclusion The esophagogastric mucosal anastomosis cardia fundus reconstruction is superior to the full-thickness anastomosis in patients with dysfunction, dysphagia, reflux less than full-thickness anastomosis and higher quality of life than the full-thickness anastomosis.