探讨腹腔镜胃癌切除残胃或食道与空肠双襻吻合围术期的观察与对策对降低术后并发症的临床意义。

回顾性分析2013年1月至2018年12月116例胃癌患者资料，所有患者围术期采用六观察与处理对策管理模式。

116例患者行根治性全胃切除术45例，远端胃大部切除术71例，手术均获得成功。术后肠蠕动恢复、肛门排气时间为3.2 d，术后住院时间为12.3 d。术后并发症发生率25.0%(29/116)，其中胃出血3例(2.5%)，十二指肠残端漏2例(1.7%)，远端胃大部切除术发生胃排空障碍7例(6.0%)，下肢静脉血栓形成3例(2.5%)，深静脉营养导管感染3例(2.5%)，肺部感染5例(4.3%)心率紊乱6例(5.1%)，均经对症治疗痊愈。无围手术期死亡，术后恢复顺利，生活质量较好。

六观察与处理对策管理模式在腹腔镜胃癌根治残胃或食道空肠双襻吻合围术期能够提高术后并发症救治效果，值得临床推广。

To explore the clinical significance of perioperative nursing observation of double loop anastomosis of remnant stomach or esophago-jejunum after laparoscopic radical gastrectomy for gastric cancer.

116 cases of double loop anastomosis of remnant stomach or esophago-jejunum after laparoscopic radical gastrectomy for gastric cancer treated in our hospital were analyzed. All the cases were treated with Six Observation and Treatment in perioperative period.

Conclusion Total gastrectomy was performed in 45 cases, distal gastrectomy was performed in 71 cases. The recovery time of intestinal function was 3.2 d, the postoperative hospital stay was 12.3 d. Gastric hemorrhage was found in 3 cases(2.5%), and cured with non-operative treatments. Duodenal stump fistula was found in 2 cases(1.7%), and cured with non-operative treatments. Gastric emptying disorder was found in 7 cases(6.0%) of distal gastrectomy, and cured with non-operative treatments after 7-28d. Venous thrombosis was found in 3 cases(2.5%). Infection of deep vein nutrition catheter was found in 3 cases(2.5%). Pulmonary infection was found in 5 cases(4.3%). Heart rate disturbance was found in 6 cases(5.1%). No cases of death was found. Postoperative quality of life of all 116 cases was good.

The nursing model of Six Observation and Treatment can improve the effect of treatment of complication, which is worthy of clinical promotion.