远端胃次全切除术后不同消化道重建方式的实验观察

doi:10.3760/cma.j.issn.0376-2491.2010.38.012

科研成果详情

题名	远端胃次全切除术后不同消化道重建方式的实验观察
其他题名	Different procedures of alimentary tract reconstruchon after subtotal distal gastrectomy in dogs
作者	叶再元 1; 孙元水 1; 张勤 2; 王元宇 3; 戴俏琼 3; 邵钦树 1; 张威 1; 吕振晔3; 徐继 1
发表日期	2010-10-19
发表期刊	中华医学杂志影响因子和分区
语种	中文
原始文献类型	学术期刊
关键词	胃切除术修复外科手术营养评价空肠间置 Ghrelin
其他关键词	Gastrectomy ; Reconstructive surgical procedures ; Nutrition assessment ; Jejunal interposition ; Ghrelin
摘要	目的探讨远端胃次全切除术后合理的消化道重建方式。方法将32只Beagle犬以随机数字表法分为4组(实验组A、B、C和对照组),每组8只。A、B、C组远端胃次全切除术后分别行残胃-十二指肠-连续性空肠间置、毕Ⅱ式、Roux-en-Y式消化道重建,对照组施以假手术。术后连续观察12周,比较各组手术前后摄食、体重、预后营养指数(PNI)和外周血Ghrelin浓度的变化。结果 A、B、C组术后摄食量、体重及PNI均较术前下降,然后缓慢回升,术后12周,A组摄食量、体重及PNI(26.8±3.3)均优于B组(25.4±3.0)和C组(25.6±3.0),差异有统计学意义(P<0.05),而B、C组间比较差异无统计学意义。A、B、C组术后第1天外周血Ghrelin浓度均较术前明显下降,1周后,Ghrelin浓度开始回升,术后12周,A组Ghrelin浓度[(280±15)pg/ml]明显高于B组[(180±10)pg/ml]和C组[(185±10)pg/ml,均P<0.05)]。对照组手术前后食量、PNI及血Ghrelin浓度无明显变化(P>0.05),术后12周后体重明显高于术前(P<0.05)。结论远端胃次全切除术后,残胃-十二指肠-连续性空肠间置术恢复了十二指肠生理通道,术后摄食量、体重及PNI恢复更快、促食激素Ghrelin代偿性分泌更明显,为一种较理想的重建术式。
其他摘要	Objective To explore an ideal procedure of alimentary tract reconstructions after subtotal distal gastrectomy. Methods Thirty-two healthy adult beagle dogs were randomly divided into experimental groups A, B, C and control group (n = 8). Groups A, B, C operated by subtotal distal gastrectomy underwent 3 different reconstruction methods : continual jejunal interposition (CJI), Billroth II and Roux-en-Y. The control group received a sham operation. Dogs were observed for 12 weeks postoperation. The different parameters of body weight, food intake, PNI (prognostic nutritional index) and peripheral blood concentration of ghrelin were measured in 4 groups. Results The body weight, food intake and PNI in Groups A, B, C decreased significantly at post-operation versus pre-operation. There was a slow elevation of body weight, food intake and PNI at Week 12. Group A was significantly better than Groups B and C (P <0. 05) while there was no significant difference between Groups B and C. The plasma ghrelin concentrations in Groups A, B, C were significantly reduced at Day 1 post-operation versus pre-operation. But no difference was observed among Groups A, B and C. However an elevated ghrelin concentration was observed at Week I post-operation. At Week 12 post-operation, the plasma ghrelin concentration in Group A increased significantly versus Groups B and C (both P < 0. 05). However, the plasma ghrelin concentration, food intake and PNI were not significantly changed in control group (P > 0. 05). Conclusions The CJI reconstruction procedure is ideally suited for the preservation of duodenal passage after subtotal distal gastrectomy. Subsequently it leads to a significant elevation of circulating ghrelin concentration and a rapid post-operative recovery of food intake, body weight and PNI
资助项目	卫生部科学研究基金（WKJ2007-2-002）
ISSN	0376-2491
卷号	90 期号:38 页码:2704-2707
DOI	10.3760/cma.j.issn.0376-2491.2010.38.012
页数	0
收录类别	CNKI ; 万方 ; 北大核心 ; PKU ; CSCD ; ISTIC
学科领域	医药、卫生 ; 特种医学
URL	查看原文
CSCD记录号	CSCD:4055975
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/70218
专题	温州医科大学附属第一医院
作者单位	1.浙江省人民医院胃肠外科; 2.浙江中医学院附属医院胃肠外科; 3.温州医学院第一附属医院
推荐引用方式 GB/T 7714	叶再元,孙元水,张勤,等. 远端胃次全切除术后不同消化道重建方式的实验观察[J]. 中华医学杂志,2010,90(38):2704-2707.
APA	叶再元., 孙元水., 张勤., 王元宇., 戴俏琼., ... & 徐继. (2010). 远端胃次全切除术后不同消化道重建方式的实验观察. 中华医学杂志, 90(38), 2704-2707.
MLA	叶再元,et al."远端胃次全切除术后不同消化道重建方式的实验观察".中华医学杂志 90.38(2010):2704-2707.