近半胃切除术食管胃前壁吻合加胃底重建抗反流作用的临床观察  

Clinical Study for Preventing Reflux Esophagitis by Anastomosis of Front Esophagus Wall in Stomach and Reconstruction of Gastric Fundus after Proximate Gastrectomy

作　　者：夏术森[1] 王崇树[1] 李勋[1] 周彤[1] 张广军[1] 魏寿江[1] 

机构地区：[1]川北医学院附属医院普外科,四川南充637000

出　　处：《川北医学院学报》2011年第4期308-310,共3页Journal of North Sichuan Medical College

基　　金：川北医学院校基金(MP-ZK-16)

摘　　要：目的:探讨近半胃切除术食管胃前壁吻合加胃底重建的抗反流作用。方法:将86例患者随机分为两组,治疗组46例行食管胃前壁吻合加胃底重建,对照组40例行食管胃后壁吻合。术后随访6个月,比较并分析两组术后上消化道钡餐检查钡剂反流入食管,胃镜示反流性食管炎,吻合口出血、狭窄、瘘及术后上腹部疼痛、烧心及反酸等并发症的差异。结果:治疗组与对照组比较,上消化道钡餐检查钡剂反流入食管、胃镜示反流性食管炎及术后上腹部疼痛、烧心及反酸等并发症明显降低,差异有统计学意义(p<0.05)。两组病人均未出现吻合口出血、狭窄及瘘。结论:近半胃切除术食管胃前壁吻合加胃底重建术能明显降低病人术后反流性食管炎及上腹疼痛、烧心及反酸等并发症,值得临床推广。Objective：To explore the prevention of reflux esophagitis by the anastomosis of front esophagus wall in stomach and reconstruction of gastric fundus after proximate gastrectomy.Methods：86 patients were randomly separated into two groups：46 patients in treatment group were performed anastomosis of front esophagus wall in stomach and reconstruction of gastric fundus,while 40 patients in control group were treated with esophagogastric anastomosis built on the back wall of the stomach.Six months after the surgery,we compared the following complications in the two groups：barium reflux into esophagus in the process of barium inspection for upper gastrointestinal,reflux esophagitis verified by gastroscopy,anastomotic hemorrhage,stenosis and fistula,epigastralgia,heartburn and sour regurgitation after the surgery.Results：Compared with control group,there was a lower rate of barium reflux into esophagus in the process of barium inspection for upper gastrointestinal,reflux esophagitis and epigastralgia,heartburn and sour regurgitation after the surgery（p0.05）.No patients in both groups suffered from anastomotic hemorrhage,stenosis or fistula.Conclusion：The anastomosis of front esophagus wall in stomach and reconstruction of gastric fundus after proximate gastrectomy could significantly decrease the complications（reflux esophagitis and epigastralgia,heartburn and sour regurgitation after the surgery）.It could be recommended widely in clinics.

关 键 词：近半胃切除 食管胃吻合 胃底重建 术后并发症 

分 类 号：R656.61[医药卫生—外科学]