食管中下段癌切除、胃食管弓上吻合两种术式对胃-食管返流及肺活量影响的研究  

The effects of two different procedures for esophage-gastroanastomosis upper arcuate on gastro-esophageal reflux and breathing capacity after medial and lower esophageal carcinoma resection

作　　者：潘越江[1] 林荣繁 宋建文 陈炬[1] 熊利华[1] 

机构地区：[1]中山医科大学孙逸仙纪念医院心胸外科,510120 [2]广西南宁市红十字会医院

出　　处：《广西医学》2002年第7期952-954,共3页Guangxi Medical Journal

摘　　要：目的 :探讨食管中下段癌切除术中 ,胸胃经食管床再经主动脉弓后与上段食管吻合术式 ,与传统上经弓前至弓上吻合术式比较 ,何种途径更能减少胃 -食管返流及肺活量的损害。方法 :对入院适合作上述术式的病例按前后两个时段分成两组 ,第 1组按传统做法 ,第 2组采取经弓后至弓上吻合 ,两组分别各完成 15例 ,共 30例。然后进行术后同位素测定返流比值及比较肺活量术前、后的改变 ,再进行统计学上的分析 ,观察它们是否存在区别及何种术式在上述两方面的功能更优。结果 :分别经两种术式处理后的病例 ,同位素返流比值及肺活量的变化均显示有显著性差异。且弓后组在减少返流及对肺活量损害等方面的功能更优。结论 :经弓后途径较弓前途径更能减少术后胃Objective:To explore which is the better procedure at reducing of gastro-esophageal reflux and breathing capacy injury between posterio-arcuate-passage and anterior-arcuate-passage esophago-gastroanastomosis in medial and lower esophageal carcinoma resection.Method:According to the operation indications and patients admission time,30 cases were divided into 2 groups of 15 each.Group 1 patients underwent traditional anterior-arcuate-passage anastomosis,and group 2 patients underwent anterior-arcuate-passage anastomosis(through the bed of esophagus),the post-operative isotopic reflux proportionality and peri-operative breathing capacity were analyzed statistically.Result:There were significant differences in changes of reflux proportionality and breathing capacity between the 2 groups after the 2 different procedures.The posterio-arcuate-passage esophage-gastroanastomosis reduced gastro-esophageal reflux and breathing capacity injury more prepotently.Conclusion:Posterio-arcuate-passage esophago-gastroanastomosis is better than anterior-arcuate-passage at reducing of gastro-esophageal reflux and breathing capacity injury.

关 键 词：胃-食管返流 肺活量 经主动脉弓前 经主动脉弓后 食管癌 外科手术 手术方式 

分 类 号：R735.1[医药卫生—肿瘤] R730.56[医药卫生—临床医学]