| objective:Explore the effects of gastric cancer patients with total onplasma total protein, hemoglobin, pre-albumin concentrations and otherindicators of quality of life from three kinds of digestive tract reconstruction,to provide a scientific way of digestive tract reconstruction for gastric cancerwith total gastrectomy. Methods:273cases of gastric cancer patients with totalgastrectomy from Sichuan Mianyang404Hospital during January2008toDecember2012, among149successful cases of follow-up25cases withmodified double tracks anastomosis（JI）were set to group A,49cases withRoux-en-Y anastomosis（RY）were set to group B,75cases with modulatinginter-generation dual-channel jejunal gastric surgery（DR）were set to group C.Compare density of plasma total protein, pre-albumin and hemoglobin amongthe three groups after6months and12months, and assess their quality of lifeby the Chew-Wu Wu Spitzer specific symptom scale and the amount of lifescore sheet. Using SPSS19.0statistical software to analysis data: count datausing chi-square test; measurement data as mean and standard deviation(x-±s), univariate analysis of variance. Test level ɑ=0.05,P<0.05wasconsidered statistically significant. Results:1.Preoperative plasma totalprotein concentration: group A66.41±3.47g/L, group B66.34±4.01g/L, groupC65.82±3.96g/L, compare the difference between the three groups was not statistically significant (F=0.371,P=0.690); hemoglobin concentration: groupA129.24±14.97g/L, group B129.98±14.85g/L, group C129.33±14.69g/L, thedifference among the three groups was not statistically significance (F=0.034,P=0.967); pre-albumin concentrations: group A327.96±12.65mg/L, groupB325.95±12.99mg/L, group C326.74±15.22mg/L, the three groups Comparethe difference was not statistically significant (F=0.145, P=0.865); After6months total plasma protein concentration: group A63.37±3.46g/L, groupB63.28±4.03g/L, group C63.98±3.99g/L, compare the difference between thethree groups was not statistically significant (F=0.541,P=0.583); hemoglobinconcentration: group A123.12±14.82g/L, group B123.78±14.60g/L, groupC123.35±14.33g/L, the difference between the three groups was notstatistically significance (F=0.021, P=0.979); pre-albumin concentrations:group A318.36±12.54mg/L, group B316.16±12.81mg/L, groupC325.31±17.61mg/L, among the three groups the difference was statisticallysignificant (F=5.713, P=0.004), among the three groups before the serumalbumin concentration pairwise comparison: group A-group B, t=1.521P=0.141, group A-group C, t=2.919P=0.008, group C-group B, t=3.647P=0.001; After12months the hemoglobin concentration: groupA133.12±14.82g/L, group B133.78±14.60g/L, groupC133.21±13.65g/L, nostatistically significant difference between the three groups (F=0.028,P=0.972); plasma total protein concentration: group A65.25±3.68g/L, groupB64.28±5.16g/L, group C67.15±4.28/L, the difference between the three groups was statistically significance (F=6.295, P=0.002), among the threegroups in plasma total protein concentration pairwise comparison: groupA-group B, t=3.555P=0.002, group A-group C, t=3.716P=0.001groupB-group C, t=2.675P=0.010; former plasma albumin concentration: groupA336.36±13.15mg/L, group B331.67±13.25mg/L, group C344.92±19.08mg/L,the difference between the three groups was statistically significant (F=10.030,P=0.000), among the three groups before the serum albumin concentrationpairwise comparison: group A-group B, t=1.781P=0.088, group A-group C,t=4.332P=0.000, group B-group C, t=4.819P=0.000;2.Spitzer score after6months comparative analysis: reconstruction of three ways, between thegeneral project activities and health indicators compared respectively P=0.004and P=0.022, with a statistically significant difference between the threegroups. Performed on the basis of any two general activities between groupA-group B P=0.016, group B-groups C P=0.001, group A-group C P=0.829;health indicators, group A-group B P=0.082, group C-group B P=0.007, groupA-group C P=0.449. In the Chew-wun wu special symptom rating scale,because different projects at different times scoring trends also vary,Chew-wun wu special symptom scores showed: the quality of life of patientsafter6months of evaluation: feeding time evaluation score of group C1.84,group A and group B were1.59and1.43, group C and group A (1.84>1.59,P=0.005) and group B (1.84>1.43, P=0.000) better able to significantlyshorten the time to eat. Food intake evaluation scores were group C1.21, group A and group B were0.61and0.59, the diet was significantly higher ingroup C group A (1.21>0.61, P=0.000) and group B (1.21>0.59, P=0.000).Heartburn or stomach belching evaluation score in group C was1.38, A and B,respectively,0.74and0.81. Group C was significantly higher than in reducingheartburn or belching aspects of group A (1.38>0.74, P=0.000) and group B(1.38>0.81,P=0.000). Quality of life of patients after12months of evaluation:Weight Rating score for the group C1.49, A and B, respectively,1.14and1.15,improving weight recovery in group C was significantly better than in group A(1.49>1.14,P=0.005) and group B(1.49>1.15,P=0.031). Heartburn or belchingevaluation score of group C1.79, A and B, respectively,1.74and1.39. GroupC and group B(1.79>1.39, P=0.006) and group A(1.74>1.39, P=0.024)compared to a significant reduction in heartburn or belching. Postprandialbloating evaluation score for the group C1.69, A and B, respectively,1.08and1.23. Group C and group A (1.69>1.08, P=0.000) and group B (1.69>1.23, P=0.000) showed relatively less bloating after meals.Conclusion:1.The densityof pre-albumin in group C was significantly higher than the other two groups.2.The quality of life in group C is superior than the other two groups.3. Thedigestive tract reconstruction In line with the physical structure of (pathwaysthrough the duodenum, and maintain continuity of jejunum) can reducepostoperative adverse reactions, improve quality of life, modulatinginter-generation dual-channel jejunal reconstruction stomach reconstructioncan be a safe and feasible way. |
PDF Full Text Request