胃癌手术不同消化道重建方式对患者术后胆囊收缩功能的影响

胃癌手术不同消化道重建方式对患者术后胆囊收缩功能的影响吴宸;姜淮芜;彭方兴;陈进;罗亮;陈汇
【期刊名称】《海南医学》
【年(卷),期】2016(027)003
【摘要】目的探讨胃癌手术不同消化道重建方式对患者术后胆囊收缩功能影响.方法选择2010年8月至2014年8月在我院接受胃癌根治术的患者60例作为研究对象.依据胃切除术后消化道重建方式的不同分成A组(n=23)及B组(n=37).A组
给予毕Ⅰ式重建,B组给予调节型双通道重建,随访1年,比较两组患者手术前后的胆囊容积、胆囊收缩功能、血清胆囊收缩素(CCK)水平以及两组的随访症状.结果 A
组患者术后3 d、7 d、1个月、6个月及12个月的胆囊容积分别为(20.89±3.12) ml、(21.23±8.10) ml、(23.64±7.88) ml、(24.94±5.32) ml、(27.84±8.81) ml,
均较术前(17.15±8.24) ml及B组术后同时期的(17.20±7.94) ml、(17.19±7.22) ml、(17.18±7.99) ml、(17.19±8.54) ml、(17.20 ± 8.20) ml明显增大,差异均有统计学意义(P<0.05);术后A组患者各时期的胆囊排空率分别为13.04%、17.39%、13.04%、17.39%、21.74%,均较B组同时期的37.84%、43.24%、40.54%、43.24%、48.65%均明显下降,差异均有统计学意义(P<0.05);术后A组患者各时期的血清CCK水平分别为(5.32 ± 0.84) pmol/L、(5.35 ± 0.76) pmol/L、(5.36 ± 0.82) pmol/L、(5.38 ± 0.77) pmol/L、(5.36 ± 0.79) pmol/L,均较B组同时期的(4.45 ± 0.39) pmol/L、(4.50 ± 0.62) pmol/L、(4.48±0.41) pmol/L、
(4.47±0.84) pmol/L、(4.51±0.33) pmol/L明显上升,差异均有统计学意义
(P<0.05);A组患者随访症状中的消化道症状及胆囊结石发生率分别为43.48%、34.78%,均较B组的2.70%、0%高,差异均有统计学意义(P<0.05).结论胃癌手术
中实施调节型双通道的消化道重建方式有利于患者术后胆囊收缩功能的恢复,可提升其生存质量,值得推荐.%Objective To discuss the effect of different digestive tract reconstruction methods on postoperative gallbladder contraction function in patients with gastric cancer. Methods Sixty patients with gastric cancer undergoing radical gastrectomy in our hospital from August 2010 to August 2014 were selected as research subjects. The patients were divided into group A (n=23) and group B (n=37) on the basis of digestive tract reconstruction method after gastrec-tomy. The group A was treated with BillrothⅠoperation, and the group B was treated with dual channel reconstruction. The patients were followed up for one year after surgery. The gallbladder volume, gallbladder contraction function, se-rum cholecystokinin (CCK) level, symptoms were compared between the two groups. Results The gallbladder volume in group A was (20.89±3.12) ml, (21.23±8.10) ml, (23.64±7.88) ml, (24.94±5.32) ml, (27.84±8.81) ml at 3 d, 7 d, 1 month, 6 months and 12 months after operation, which was significantly higher than that before operation [(17.15 ± 8.24) ml] and those in group B [(17.20±7.94) ml, (17.19±7.22) ml, (17.18±7.99) ml, (17.19±8.54) ml, (17.20±8.20) ml, respectively]. The differences were statistically significant (P<0.05). The gallbladder emptying rate in group A after operation was 13.04%, 17.39%, 13.04%, 17.39%, 21.74%at 3 d, 7 d, 1 month, 6 months and 12 months after operation, which was sig-nificantly lower than that in group B of 37.84%, 43.24%, 40.54%, 43.24%,
48.65%(P<0.05). The serum CCK level in the group A after operation was (5.32 ± 0.84) pmol/L, (5.35 ± 0.76) pmol/L, (5.36 ± 0.82) pmol/L, (5.38 ±
0.77) pmol/L, (5.36 ± 0.79) pmol/L, which was significantly higher than that in group B of (4.45 ± 0.39) pmol/L, (4.50 ± 0.62) pmol/L,(4.48±0.41) pmol/L, (4.47±0.84) pmol/L, (4.51±0.33) pmol/L (P<0.05). The incidences of digestive tract symptoms and gallbladder stones in group A were 43.48%, 34.78%, which were significantly higher than those in group B of 2.70%, 0%, and the differences were statistically significant (P<0.05). Conclusion The implementation of dual channel recon-struction in gastric cancer surgery is beneficial to the recovery of gallbladder contraction function, which can improve the quality of life and is worth recommending.
【总页数】3页(P381-383)
【作者】吴宸;姜淮芜;彭方兴;陈进;罗亮;陈汇
【作者单位】川北医学院附属第二医院胃肠外科,四川绵阳 621000;川北医学院附属第二医院胃肠外科,四川绵阳 621000;川北医学院附属第二医院胃肠外科,四川
绵阳 621000;川北医学院附属第二医院胃肠外科,四川绵阳 621000;川北医学院附属第二医院胃肠外科,四川绵阳 621000;川北医学院附属第二医院胃肠外科,四川
绵阳 621000
【正文语种】中文
【中图分类】R735.2
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