本文關(guān)鍵詞： 胃酸PH值 胃泌素 胃癌術(shù)后 胃腸功能恢復(fù)　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:胃癌術(shù)后患者出現(xiàn)胃腸功能障礙,導(dǎo)致患者心理及生理機(jī)能出現(xiàn)嚴(yán)重負(fù)面作用,延長(zhǎng)患者住院總天數(shù),增加病人住院總費(fèi)用,并對(duì)以后必要放化療的選擇出現(xiàn)治療延誤拖延,對(duì)胃癌預(yù)后造成不利影響。本研究旨在通過(guò)比較胃癌患者術(shù)前術(shù)后殘胃胃酸的程度及胃泌素變化,觀察不同患者的胃腸功能恢復(fù)與其高低是否有相互關(guān)聯(lián),為胃腸功能恢復(fù)的評(píng)價(jià)提供參考依據(jù)。方法:1、收集我院2014年5月-2016年9月資料完整、經(jīng)病理確診的、臨床分期為ⅠB~IV期的胃癌病例82例,所有病例均行限期胃癌根治術(shù)。2、在我院檢驗(yàn)科檢驗(yàn)實(shí)驗(yàn)室檢測(cè)患者空腹血清胃泌素水平,記錄手術(shù)前一天及術(shù)后第1、7天空腹血清胃泌素?cái)?shù)值;術(shù)前及術(shù)后第1、3、5、7天經(jīng)胃管抽液測(cè)殘胃PH變化。3、記錄患者手術(shù)時(shí)間、術(shù)中失血量、胃管拔除時(shí)間、引流管拔除時(shí)間、肛門排氣時(shí)間、開始進(jìn)食時(shí)間、術(shù)后住院時(shí)間和住院總時(shí)間等。將術(shù)后5天停胃腸減壓,保留空腸營(yíng)養(yǎng)管,7天經(jīng)口自主進(jìn)食流質(zhì)飲食,未出現(xiàn)不適癥狀患者設(shè)為對(duì)照組。不能按時(shí)進(jìn)食水或7天后進(jìn)食水后再次出現(xiàn)腹脹、惡心、嘔吐等癥狀,12小時(shí)不能恢復(fù)繼續(xù)進(jìn)食水并排除吻合口狹窄患者設(shè)為觀察組。4、計(jì)量資料采用t檢驗(yàn),計(jì)數(shù)資料采用χ2檢驗(yàn),P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:1、對(duì)照組手術(shù)時(shí)間、術(shù)中失血量、肛門排氣時(shí)間、胃管拔除時(shí)間、引流管拔除時(shí)間、術(shù)后住院時(shí)間分別為(2.92±0.3)h、(453.1±131.9)ml、(42.18±15.62)h、(4.52±0.7)d、(5.82±0.81)d、(12.82±0.81)d,觀察組分別為(3.08±0.55)h、(542.8±75.6)ml、(74.26±11.53)h、(6.73±0.51)d、(5.87±0.66)d、(14.08±0.84)d,兩組在肛門排氣時(shí)間、胃管拔除時(shí)間及術(shù)后住院時(shí)間比較差異均有統(tǒng)計(jì)學(xué)意義(均P0.05)。2、胃癌患者術(shù)前術(shù)后血清胃泌素變化呈V形,術(shù)后第1天較術(shù)前呈明顯下降,于術(shù)后逐漸升高,至1周左右接近術(shù)前水平。兩組無(wú)明顯統(tǒng)計(jì)學(xué)差異。3、胃癌患者術(shù)后胃酸PH值較術(shù)前增高并于術(shù)后1周略有降低;行遠(yuǎn)端胃癌根治術(shù)患者PH數(shù)值明顯高于近端胃癌根治患者。術(shù)后第5天兩組統(tǒng)計(jì)學(xué)有差異。結(jié)論:胃癌術(shù)后胃腸功能恢復(fù)與患者的血清胃泌素?zé)o相關(guān)性,與胃酸PH的水平有一定的相關(guān)性。
[Abstract]:Objective: gastrointestinal dysfunction was found in patients with gastric cancer after operation, which resulted in serious negative effects of psychological and physiological functions, prolonged the total days of hospitalization, and increased the total cost of hospitalization. This study was designed to compare the degree of gastric acid and gastrin in gastric cancer patients before and after operation. To observe the correlation between the recovery of gastrointestinal function and the level of gastrointestinal function in different patients, and to provide a reference for evaluating the recovery of gastrointestinal function. Methods: 1. The data of our hospital from May 2014 to September 2016 were collected and confirmed by pathology. 82 cases of gastric cancer with stage 鈪，

本文編號(hào)：1552919