本文選題：幽門成形術(shù) + 近端胃切除術(shù)　； 參考：《重慶醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的：探討使用直線切割閉合器行幽門成形術(shù)在賁門胃底部占位性病變行近端胃切除術(shù)后的臨床療效。方法： 選取2010.01-2013.12期間我科收治近端胃占位性病變患者共計(jì)94例,其中實(shí)驗(yàn)組(A組)54例,其中28例胃底賁門癌病例均行近端胃癌根治性切除(D2),26例良性占位性病變病例行近端胃切除,所有病例在上述操作基礎(chǔ)上均使用直線切割閉合器行幽門成形術(shù)。對(duì)照組(B組)40例,胃底賁門癌22例、良性占位性病變18例,手術(shù)處理原則上均同實(shí)驗(yàn)組(A組),但不附加幽門成形術(shù)。結(jié)果：兩組患者一般資料情況差異無統(tǒng)計(jì)學(xué)意義(P0.05)；實(shí)驗(yàn)組(A組)患者術(shù)后胃管留置時(shí)間、胃管引流量、腸道功能恢復(fù)時(shí)間、平均住院時(shí)間,遠(yuǎn)期并發(fā)癥,如：術(shù)后3月患者出現(xiàn)餐后飽脹不適、反酸、胸骨后燒灼感等反流性食管炎臨床表現(xiàn)的發(fā)生率、胃鏡提示反流性食管炎、幽門狹窄的發(fā)生率較對(duì)照組(B組)差異有統(tǒng)計(jì)學(xué)意義(P0.05)；兩組患者胃癱發(fā)生率無顯著性差異(P0.05)。結(jié)論：在近端胃切除術(shù)中使用直線切割閉合器進(jìn)行幽門成形術(shù)可減少胃潴留及反流性食管炎的發(fā)生,減少住院時(shí)間,有利于患者術(shù)后恢復(fù),適合臨床推廣應(yīng)用。
[Abstract]:Objective: to investigate the clinical effect of pyloroplasty with linear cutting closure in proximal gastrectomy of gastric cardia. Methods: a total of 94 patients with proximal gastric space occupying lesions were treated in our department during 2010.01-2013.12, including 54 cases in group A, 28 cases of gastric fundus cardia carcinoma were treated with radical resection of proximal gastric carcinoma and 26 cases of benign space occupying lesions were treated with proximal gastrectomy. All patients underwent pyloroplasty using a linear cut-closure device on the basis of the above procedures. There were 40 cases of gastric fundus cardia carcinoma, 22 cases of gastric fundus cardia carcinoma and 18 cases of benign space occupying lesion in control group B. The surgical treatment was in principle the same as that in group A, but no pyloroplasty was added. Results: there was no significant difference in general data between the two groups (P 0.05, group A). The time of gastric tube indwelling, the drainage of gastric tube, the recovery time of intestinal function, the average time of hospitalization and the long-term complications were observed in group A (group A), group A (group A). For example, the incidence of postprandial fullness and discomfort, acid reflux, poststernal burning and other clinical manifestations of reflux esophagitis were observed 3 months after operation, and gastroscopy indicated reflux esophagitis. The incidence of pyloric stenosis was significantly higher than that of control group B (P 0.05), and there was no significant difference in the incidence of gastroparesis between the two groups. Conclusion: pyloroplasty with linear incision closure in proximal gastrectomy can reduce gastric retention and reflux esophagitis, reduce hospitalization time, and be suitable for clinical application.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R735.2

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