食管胃机械吻合术后胸腔内残余食管胃功能的研究  

Function of remnant esophagus intra-thoracic stomach after gastroesophageal stapled anastomosis in excision for cardiac cancer

作　　者：李捷[1] 刘颖[1] 俞建琦[1] 

机构地区：[1]解放军总医院第一附属医院胸心外科,北京100037

出　　处：《第四军医大学学报》2008年第3期277-279,共3页Journal of the Fourth Military Medical University

摘　　要：目的:探讨贲门癌切除食管胃机械吻合术后胸腔内残余食管胃的功能及反流情况.方法:对41例贲门癌切除术后患者进行內窥镜检查、食管腔内压力测定和24hpH监测.结果:内窥镜检查发现吻合口上方食管黏膜有异常改变者占70.7%(29/41).测压显示41例患者术后吻合口压力低于对照组食管下括约肌和残余食管压力(P<0.05).术后组平均残余食管静息压高于对照组平均食管静息压和胸内胃的平均静息压(P<0.05);24h食管pH监测结果表明两组间pH<4的立位、卧位、pH<4总时间、反流次数等均存在统计学差异(P<0.01),卧位与立位PH<4的总时间有统计学差异(P<0.01).结论:贲门癌切除食管胃机械吻合术后,必然存在食管反流;吻合口处虽存在高压区,但不具有抗反流作用.AIM： To investigate the function of remnant esophagus intrathoracic stomach after excision for cardiac cancer undergoing gastroesophageal stapled anastomosis. METHODS： Fortyone patients were examined by endoscopy and measured by using computer manometer and 24 h pH monitoring in esophageal lumen. RESULTS： Abnomalities were found in 70.7% patients through endoscopy and pathological examination. Resting pressure under the esophagus- gastric anastomosis was higher than that in the remnant esophagus and intrathoracic stomach in the patients （P 〈 0. 05 ）, and resting pressure of remnant esophagus was higher than that of normal esophagus （ P 〈 0.05 ）. There was significant difference between the patients and normal people in 24 h pH monitoring （P 〈 0. 01 ）. CONCLUSION： There is a high pressure zone under the esophago-gastric anastomosis, gastroesophageal reflux exists in the patients after excision for esophageal carcinoma and cardiac cancer.

关 键 词：贲门肿瘤 机械吻合 测压 PH监测 

分 类 号：R735.2[医药卫生—肿瘤]