摘要
目的:探究消化性溃疡患者胃大部切除术后发生残胃癌的危险因素,并提出相应干预措施。方法:选取我院收治的行胃大部切除术治疗后的消化性溃疡患者180例作为研究对象,将其随机分为两组,每组90例。对照组给予常规干预,观察组给予综合干预,观察两组的干预效果,同时将发生残胃癌患者与未发生残胃癌患者各项资料进行对比,分析影响残胃癌发生的危险因素。结果:观察组中没有患者发生残胃癌,对照组中有10例患者发生残胃癌,发生率为11.11%,显著高于观察组(P<0.05);两组患者在首次手术年龄、性别、HP感染上进行对比差异无统计学意义(P>0.05);两组患者在首次手术吻合方式、首次手术溃疡位置上对比具有统计学意义(P<0.05),残胃癌组组采用毕Ⅰ式2例,毕Ⅱ式7例,Roux-Y式1例;未发生残胃癌组采用毕Ⅰ式82例,毕Ⅱ式74例,Roux-Y式14例,残胃癌组首次手术溃疡位置以十二指肠球部为主,未发生残胃癌组以十二指肠球部、胃体部为主;Logistics回归分析结果证实首次手术吻合方式、首次手术溃疡位置属于残胃癌发生的主要危险因素。结论:术后残胃癌发生危险因素包括首次手术吻合方式、首次手术溃疡位置,同时相关并发症的发生同样会增加术后残胃癌发生风险,应加强引流管干预、并发症干预,并将此作为基础制定综合干预方案。
Objective: To analyze the risk factors for gastric stump cancer of peptic ulcer patients after accepting the subtotal gastrectomy and propose corresponding intervention measures. Methods: 180 patients with peptic ulcer disease after accepting the subtotal gastrectomy and randomly were divided into 2 groups. Provide the regular intervention for the control group and provide comprehensive intervention for observation group to obverse the intervention effects. Compare each detail information of patient with gastric stump cancer with that of patient without gastric stump cancer to obverse the risk factors causing gastric stump cancer. Results: There were no cases of gastric stump cancer in the observation group and 10 cases in the control group(11.11%, P<0.05), and there was no significant difference in the age and sex of HP infection between the two groups(P>0.05). There were significant differences between the two groups in the anastomosis of the first operation and the location of ulcer in the first operation(P<0.05). In the gastric stump gastric cancer group,there were 2 cases of type Ⅰ and 1 case of type Ⅱ Roux-Y, and 82 cases of type Ⅰ were used in the group without residual gastric cancer. A report of 74 cases of Bi Ⅱ type Roux-Y type 14 In the gastric stump group, duodenal bulbar was the main location of ulcer in the first operation, and the duodenal bulbar and gastric body were the main anastomosis in the gastric remnant group. The results of logistic regression analysis confirmed the anastomosis of the first operation. The location of ulcer in the first operation is the main risk factor of gastric stump cancer. Conclusion: The risk factors that may cause gastric stump cancer after surgery include the surgical anastomosis kinds and surgical ulcer position of the first surgery. Meanwhile, the incidence of related complications will also increase the gastric stump cancer incidence rate. Therefore, the comprehensive intervention plan, including strengthening drainage tube intervention and complications intervention, shall be established based on this.
作者
荣媛
刘明华
邓朝霞
任小宝
向强
RONG Yuan;LIU Ming-hua;DENG Zhao-xia;REN Xiao-bao;XIANG Qiang(Department of emergency, Southwest Hospital in Third Military Medical University, Chongqing,400038,China)
出处
《现代生物医学进展》
CAS
2019年第15期2869-2872,2903,共5页
Progress in Modern Biomedicine
基金
国家自然科学基金项目(81071537)
关键词
胃大部切除术
消化性溃疡
残胃癌
危险因素
Subtotal gastrectomy
Peptic ulcer
Gastric stump cancer
Risk factors
