目的 探讨改良胃空肠Roux-en-Y吻合术在胃癌手术中的应用及对胃肠功能的影响。方法 回顾性选择2020年1月—2023年1月襄阳市襄州区人民医院普外科收治的手术治疗的152例胃癌患者为研究对象。根据手术方法不同分为对照组和观察组,每组各76例。对照组采用开放手术后行毕Ⅰ式吻合术治疗,观察组采用开放手术后行改良胃空肠Roux-en-Y吻合术治疗。比较两组患者手术前后血清肿瘤标志物[癌胚抗原（CEA）、糖类抗原19-9（CA19-9）、糖类抗原125（CA125）、甲胎蛋白（AFP）]水平、术后胃肠功能指标,术后6个月评估并比较两组患者并发症发生情况。结果 两组治疗后血清肿瘤标志物CEA、CA19-9、CA125、AFP水平均较术前降低（P<0.05）,但两组间差异无统计学意义（P>0.05）;治疗后观察组患者的术后排气、肠鸣音恢复、首次进食及首次排便所需时间均长于对照组（P<0.05）;两组患者术后吻合口漏、感染、胃出血、肠梗阻、胃瘫、体质变差及手术切口愈合不良等并发症的总发生率比较,差异无统计意义（P>0.05）。结论 改良胃空肠Roux-en-Y吻合术用于胃癌手术患者中,未增加不良反应发生率,但是相较于毕Ⅰ式吻合术,对患者胃肠道影响稍大,临床上应根据患者情况选择合适的手术方式,以改善患者预后。

Objective To explore the application of modified Roux-en-Y gastrojejunostomy in gastric cancer surgery and its impact on gastrointestinal function. Methods A retrospective study was conducted on 152 gastric cancer patients admitted to the General Surgery Department of Xiangzhou District People's Hospital in Xiangyang City from January 2020 to January 2023. They were divided into two groups with 76 patients in each group based on different surgical methods. The control group was treated with open surgery and Billroth Ⅰ anastomosis, while the observation group was treated with open surgery and modified Roux-en-Y anastomosis. The serum tumor marker levels [carcinoembryonic antigen （CEA）, carbohydrate antigen 19-9 （CA19-9）, carbohydrate antigen 125 （CA125）, alpha-fetoprotein （AFP）] before and after surgery, postoperative gastrointestinal function indicators, and incidence of complications 6 months after surgery were compared between the two groups. Results After treatment, the serum levels of tumor markers CEA, CA19-9, CA125, and AFP in the two groups were lower than those before treatment （P<0.05）, but no differences were found between the two groups （P>0.05）. After treatment, the observation group had longer postoperative exhaust, bowel sound recovery, first meal intake, and first bowel movement time than the control group （P<0.05）. There was no statistically significant difference in the overall incidence rate of complications such as anastomotic leakage, infection, gastric bleeding, intestinal obstruction, gastric paralysis, physical deterioration, and poor surgical incision healing between the two groups of patients （P>0.05）. Conclusion The modified Roux-en-Y gastrojejunostomy for patients undergoing gastric cancer surgery does not increase the incidence of adverse reactions. However, it has a greater impact than Billroth Ⅰ anastomosis on the gastrointestinal tract of patients. In clinical practice, appropriate surgical methods should be selected based on the patient's condition to improve prognosis.