胃癌切除消化道重建手术中不同吻合技术的应用效果分析

摘要

Objective To discuss the effect of different anastomosis techniques in gastrectomy gastrointestinal reconstructive surgery. Methods 100 patients with gastrectomy gastrointestinal reconstructive surgery in our hospital from January 2014 to January 2016 were divided into three groups by different methods,Group A(n = 32)was given double anastomosis,Group B(n = 37)was given anastomosis technology while Group C(n = 31)was received domestic stapling technique,the mean operative time,anastomotic leakage,anastomotic stenosis incidence of post-operative complications and postoperative diet of the three groups were analyzed statistically. Results The average operative time of Group B (190. 32 ± 10. 21)min and Group C(178. 33 ± 9. 30)min were significantly less than thatmin of Group A(231. 39 ± 11. 01),the differences were statistically significant( P 0. 05). Conclusion The double an-astomosis and anastomosis technology could significantly shorten the operation time,and have lower incidence of postoperative complications. The method were safe and conducive to postoperative recovery,which can be applied in clinical use.%目的：探讨不同吻合技术在胃癌切除消化道重建手术中的应用效果。方法将2014年1月至2016年1月收治的100例行胃癌切除消化道重建手术的患者根据手术方法不同分为三组，其中 A 组患者（n =32）采取双层吻合技术，B 组患者（n =37）采取单层吻合技术，C 组患者（n =31）采取国产吻合器吻合技术，比较三组患者平均手术时间、吻合口漏和吻合口狭窄等术后并发症的发生率及术后饮食情况，并进行统计学分析。结果 B 组和 C 组患者平均手术时间分别为（190.32±10.21）min 和（178.33±9.30）min，均显著少于 A 组的（231.39±11.01）min，差异均具有统计学意义（ P ＜0.05）。B 组吻合口漏和吻合口狭窄的发生率分别为3.23%和3.23%，C 组吻合口漏和吻合口狭窄的发生率分别为2.70%和0.00%，均显著低于 A 组的9.38%和12.50%，差异均具有统计学意义（ P ＜0.05）。三组患者随访半年，未出现死亡病例，且 B 组和 C 组患者日均饮食量和饮食次数均优于 A 组患者，但差异无统计学意义（ P ＞0.05）。结论在胃癌切除消化道重建手术中单层吻合和吻合器吻合均可明显缩短患者手术时间，且术后并发症发生率低，安全性高，利于患者术后恢复，具有较好的临床应用效果。