管状胃替代食管对食管癌术后胃动力学的影响  

Influence of gastric dynamics on tube stomach replacement of the esophagus after the esophageal carcinoma operation

作　　者：周钢[1] 邢宇彤[1] 乔峰[1] 窦鹏挥[1] 

机构地区：[1]佳木斯大学附属第一医院胸心外科,黑龙江佳木斯154002

出　　处：《局解手术学杂志》2013年第1期50-52,共3页Journal of Regional Anatomy and Operative Surgery

基　　金：黑龙江省卫生厅科技立项课题(2010-516)

摘　　要：目的探讨食管癌手术最佳的胸腔胃解剖形态与蠕动排空功能的关系,以正确指导食管癌的手术治疗,减少术后消化道并发症和提高手术疗效。方法将70例食管癌病例依据手术中胸胃剪切后胃的形状不同随机分为2组,管胃组35例和全胃组35例。利用食管胃功能测试仪在术前和术后对食管癌病例进行了胸胃静息压、蠕动收缩压和蠕动频率的检测,以及术后胸胃排空功能的X线消化道造影评价。结果 2组胸胃功能术后较术前均下降,管胃组术后胸胃的静息压为(6.20±1.55)mmHg,蠕动收缩压(36.40±3.86)mmHg,蠕动频率(5.30±1.95)次/分;全胃组分别为(4.70±1.42)mmHg,(27.50±3.63)mmHg和(4.60±1.26)次/分。前者静息压和收缩压数值明显大于后者,但蠕动频率两者无差异(P分别是0.012,0.000和0.373)。管胃组术后胸胃的排空率明显高于全胃组(P<0.05)。结论食管癌切除胃替代食管手术管状胃的胃动力学参数和胃排空功能等均优于全胃,管状胃的术后并发症也少于全胃,建议食管癌手术中尽量采取管状胃替代食管。Objective In order to reduce postoperative digestive tract complications and improve surgical effects,the relation between the best thoracic stomach anatomy and peristaltic emptying function after esophagectomy was investigated for the correct guidance of esophageal cancer surgery.Methods Based on the different thoracic stomach shapes after operation 70 cases of esophageal cancer cases were divided into two groups,35 cases of tube gastric group and 35 cases of original stomach group.The thoracic stomach resting pressure,peristalsis systolic pressure and peristaltic frequency were detected by the esophageal and gastric function tester before and after esophageal cancer surgery and thoracic gastric emptying function was evaluated by the X-ray digestive tract imaging.Results Both of the two groups＇ thoracic gastric function after surgery decreased compared with preoperative period,after operation the tube stomach group resting pressure was（6.20±1.55） mmHg,peristaltic systolic pressure（36.40±3.86） mmHg,peristaltic frequency（5.30±1.95） times/min;but the original gastric group were（4.70±1.42） mmHg,（27.50±3.63） mmHg and（4.60±1.26） times/min.The former group was much larger than the latter（P= 0.012,0.000 and 0.373）.The emptying function of thoracic tube stomach group was significantly higher than the original stomach group（P0.05）.Conclusion In esophagectomy of esophageal carcinoma and stomach replacement of esophagus operation the dynamics parameters of tube stomach one and thoracic gastric emptying function better than the original stomach,the surgical complications of tube group was less than original group.We recommended that tube stomach replacement of esophagus could be taken as possible as in esophageal surgery.

关 键 词：食管癌 胃替代食管 胸胃形态 管状胃 

分 类 号：R735.1[医药卫生—肿瘤]