双S空肠间置术预防贲门癌切除术后反流性食管炎  

Double S-Jejunum Interposition in Prevention of Reflux Esophagitis after Resection of Carcinoma of Gastric Cardia

作　　者：檀振波[1] 霍志彬[1] 肖其海[1] 翟同善[1] 刘立水[1] 霍春平 

机构地区：[1]邢台市人民医院肿瘤科,河北省邢台市054031

出　　处：《中国肿瘤临床》1999年第7期523-525,共3页Chinese Journal of Clinical Oncology

摘　　要：目的：探讨消化道重建方式对贲门癌切除术后反流性食管炎的预防作用。方法：自１９９５ 年２ 月～１９９６ 年１０ 月采用双Ｓ空肠间置术行贲门癌切除术后消化道重建，并以传统的食管胃吻合法作对照。将术后无病生存１ 年以上的７４ 例作为本文观察对象。其中双Ｓ组３８ 例，传统组３６ 例。结果：１） 食管胃反流症状发生率：传统组７５％ ，双Ｓ组５．３％ ，两组间有非常显著性差异（ Ｐ＜０．０１） 。２）ｐＨ 值测定：食管下段ｐＨ 平均值传统组４．８ ，双Ｓ组６．９ ，两组间有显著性差异（ Ｐ＜ ０．０５）。３） 上消化道钡餐造影：传统组２３ 例发现钡剂反流入食管，发生率为６３．９％ ，双Ｓ组仅有４例，发生率为１０．５％ ，两组间有非常显著性差异（ Ｐ＜０．０１） 。结论：采用Ｓ空肠间置术行消化道重建对预防贲门癌切除术后反流性食管炎具有良好的临床效果。该手术方法简便，不受残胃大小的限制，间置空肠血运良好，优于目前采用的其它抗反流手术，值得推广应用。To prevent reflux esophagigits after resection of carcinoma of gastric cardia, a double S-jejunum interposition (DS) technique was performed on 38 cases and compared with traditional esophagogastrectomy in 36 cases. The results showed that 1) The incidence rate of reflux esophagitis was 75%in patients after traditional surgery and was only 5.3%after DS operation; 2)The mean pH value in the lower part of esophagus was 4 8 in traditional surgery group, while in patients treated with DS it was 6 9 ( P<0 05 ); 3) Twenty-three (63 9%)cases of reflux esophagitis was diagnosed by X-ray examination in traditional surgery group, whereas in DS group there were only 4 cases (10 5%). It is concluded that DS technique can effectively prevent the reflux esophagitis after resection of cancer of gastric cardia and is preferable to other anti-reflux operation.

关 键 词：贲门癌 治疗 反流性食管炎 空肠间置 外科手术 

分 类 号：R735.105[医药卫生—肿瘤]