食管、贲门癌切除机械吻合术后反流性食管炎的临床研究  

Correlation between proxim subtotal gastrectomy for cardiac cancer undergoing stapled anastomosis and gastroesophageal reflux

作　　者：张勇[1] 高平[2] 王胜[1] 

机构地区：[1]宁夏银川市第一人民医院,宁夏银川750001 [2]宁夏医科大学附属医院,宁夏银川750004

出　　处：《宁夏医学杂志》2009年第1期51-52,共2页Ningxia Medical Journal

摘　　要：目的探讨食管癌和贲门癌术后食管胃机械吻合术后重建食管与胃食管反流之间的关系。方法对214例食管癌和贲门癌切除术后患者采用多指标检测方法,其中食管造影检查106例、电子胃镜检查108例并取病理检查43例。结果食管造影检查反流为70%,弓上吻合反流低于弓下吻合(P<0.05);胃镜检查86%有异常表现,其发生与术后时间长短无关(P>0.05),反流性食管炎评分弓上吻合明显低于弓下吻合(P<0.05)。结论食管贲门癌切除食管胃机械吻合术后,广泛存在胃食管反流,反流的发生与术后时间的长短无关,食管胃吻合口位置越高胃食管反流和反流性食管炎程度越轻。Objective To investigate the relation between proximal subtotal gastrectomy for cardiac cancer undergoing stapled anastomosis and gastroesophageal reflux. Methods 214 patients were studied by using multiple index detecting method, including 106 cases by esophagus radiography examination, 108 cases by endoscopy examination, 43 cases by endoscopy examination biopsy. Results There were 70% patients had reflux in esophagus radiography examination, reflux in undergoing esophagogastric stapled anastomosis below the aortic arch was significantly higher than that above the aortic arch （P 〈0.05）. Abnormalities were found in 86% of patients through endoscopy, occurrence of which was not affected by the length of postoperative period （ P 〉 0.05 ）, score of reflux esophagitis in undergoing esophagogastric stapled anastomosis below the aortic arch was significantly higher than that above the aortic arch （P 〈 0.05 ）. Conclusion gastroesophageal reflux exists widely in the patients after excision for esophageal carcinoma and cardiac cancer undergoing esophagogastric stapled anastomosis. The occurrence of gastroesophageal reflux is not affected by the length of postoperative period. Stapled anastomosis below the aortic arch is more likely to be followed by gastroesophageal reflux and esophagitis.

关 键 词：食管癌 贲门癌 反流性食管炎 机械吻合 

分 类 号：R735[医药卫生—肿瘤] R571[医药卫生—临床医学]