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河北医学  2019, Vol. 25 Issue (4): 639-642    DOI: 10.3969/j.issn.1006-6233.2019.04.030
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细管状胃代食管术预防食管胃吻合口瘘的疗效 及对患者术后短期生存质量的影响
匡必婧1, 胡杨1, 余娜1, 马林1, 宋尚岐2
1.四川大学华西医院胸外科, 四川 成都 610000
2.四川省成都市上锦南府医院胸外科, 四川 成都 610000
Curative Effect of Thin-tube Transgastric Esophagus on Prevention of Esophagogastric Anastomotic Leakage and its Effect on Short-term Quality of Life after Operation
KUANG Bijing, HU Yang, YU Na, et al
West China Hospital of Sichuan University, Sichuan Chengdu 610000, China
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摘要 目的:探讨细管状胃代食管术预防食管胃吻合口瘘的疗效及对患者术后短期生存质量的影响。方法:选取2016年12月至2018年2月在我院行食管癌切除术的患者120例,应用简单随机分组方法分为细管状胃组(n=60)和粗管状胃组(n=60),细管状胃组食管癌手术切除后制作细管状胃,粗管状胃组食管癌手术切除后制作粗管状胃;比较两组手术一般情况、术后并发症,并参照欧洲癌症研究与治疗组织(EORTC)癌症患者生活质量QLQ-C30量表及食管癌专用QLQ-OES18量表制定生活质量评价表对患者术后6个月生活质量进行调查。结果:两组手术时间、术中出血量、术后引流量、术后住院时间无统计学差异(P>0.05)。细管状组吻合口瘘、反流性食管炎发生率均明显低于粗管状组(P<0.05),而两组吻合口狭窄、肺部感染、心律失常、胸胃综合征发生率无统计学差异(P>0.05)。术后6个月,细管状胃组生活质量量表中功能性维度评分明显高于粗管状胃组(P<0.05),而症状性维度评分明显低于粗管状胃组(P<0.05)。结论:细管状胃代食管术能够有效减少术后吻合口瘘发生,提高患者短期生存质量。
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关键词 食管癌细管状胃吻合口瘘生存质量    
AbstractObjective: To investigate the curative effect of thin-tube transgastric esophagus on prevention of esophagogastric anastomotic leakage and its effect on short-term survival quality. Methods: 120 patients undergoing esophageal cancer resection in the hospital from December 2016 to February 2018 were divided into the thin tubular stomach group (n=60) and the thick tubular stomach group (n=60) by simple randomization method. The thin tubular stomach was made after esophageal cancer resection in the thin tubular gastric group. The thick tubular stomach was made after esophageal cancer resection in the thick tubular gastric group. the general conditions and postoperative complications of the two groups were compared, and the European Cancer Research and Treatment Organization (EORTC), the QLQ-C30 scale for cancer patients and the QLQ-OES18 scale for esophageal cancer were used to establish a quality of life assessment form to investigate the quality of life of patients 6 months after surgery. Results: There were no significant differences in operation time, intraoperative blood loss, postoperative drainage, and postoperative hospital stay between the two groups (P>0.05). The incidence of anastomotic leakage and reflux esophagitis in the thin tubular group was significantly lower than that in the thick tubular group (P<0.05), the incidence of anastomotic stenosis, pulmonary infection, arrhythmia, and chest and stomach syndrome had no statistically significant difference (P>0.05). At 6 months after surgery, the functional dimension scores in Quality of life scale of the thin tubular stomach group were significantly higher than those of the thick tubular stomach group (P<0.05), while the symptomatic dimension scores were significantly lower than those of the thick tubular stomach group (P<0.05). Conclusion: Thin-tube transgastric esophagectomy can effectively reduce the occurrence of postoperative anastomotic leakage and improve the short-term quality of life.
Key wordsEsophageal cancer    Thin tubular stomach    Anastomotic leakage    Quality of life
    
基金资助:四川省科技厅计划项目,(编号:2018JY0596)
引用本文:   
匡必婧, 胡杨, 余娜, 马林, 宋尚岐. 细管状胃代食管术预防食管胃吻合口瘘的疗效 及对患者术后短期生存质量的影响[J]. 河北医学, 2019, 25(4): 639-642.
KUANG Bijing, HU Yang, YU Na, et al. Curative Effect of Thin-tube Transgastric Esophagus on Prevention of Esophagogastric Anastomotic Leakage and its Effect on Short-term Quality of Life after Operation. HeBei Med, 2019, 25(4): 639-642.
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