保留迷走神经干对早中期食管贲门癌切除术患者的疗效及预后影响  

The Effect of Preserving Vagus Trunks on the Efficacy and Prognosis of Patients with Early and Middle Esophageal Cardiac Cancer Underwent Radical Surgery

作　　者：车金泽[1] 季福建 刘选文[3] 赵阳 房学东[5] 

机构地区：[1]吉林大学第二医院,132000 [2]中日联谊医院新民分院胃肠外科,132000 [3]吉林市中心医院普外科,132000 [4]中日联谊医院胃肠外科,132000 [5]吉林大学第三医院普通外科医院,132000

出　　处：《实用癌症杂志》2015年第3期386-388,共3页The Practical Journal of Cancer

摘　　要：目的探讨保留迷走神经干对早中期食管贲门癌切除术患者的疗效及预后影响。方法将120例早中期食管贲门癌切除术患者,随机分为对照组(切断迷走神经干)和观察组(保留迷走神经干),每组各60例,观察和比较两组术后首次排气、首次排便时间,术后胃肠激素水平变化情况,术后1个月食管体部及胃的静息压变化情况,以及术后并发症发生率。结果与对照组相比,观察组首次排气时间、首次排便时间均明显缩短,P<0.05;与对照组相比,观察组术后胃酸分泌量、胃泌素水平均明显降低,胰多肽水平显著提高,P<0.05;与对照组相比,观察组术后1个月食管体部静息压明显升高,P<0.05;与对照组相比,观察组术后返酸、嗳气、胸骨烧灼感等并发症发生率显著降低,P<0.05。结论保留迷走神经干能够提高早中期食管贲门癌切除术患者的预后质量,降低术后并发症发生率,有效保护患者术后消化功能。Objective To study the effect of preserving vagus trunks on the efficacy and prognosis of patients with early and middle esophageal cardiac cancer underwent radical surgery. Methods 120 cases of early and middle esophageal cardiac cancer underwent radical surgery were randomly divided into the control group( vagotomy) and the observation group( preserving vagus trunks),60 patients per group. The postoperative first exhaust time,first defecation time,the level changes of gastrointestinal hormone,the resting pressure changes of esophageal body and gastric tissues 1 month after operation,and the incidence of postoperative complications of the 2 groups were observed and compared. Results Compared with the control group,the postoperative first exhaust time and first defecation time in the observation group were significantly shorter( P < 0. 05); compared with the control group,the levels of postoperative gastric acid secretion and gastin in the observation group significantly decreased,and the level of pancreatic polypeptide obviously increased( P < 0. 05); compared with the control group,the resting pressure changes of esophageal body 1 month after operation significantly increased in the observation group( P < 0. 05); compared with the control group,the incidence of postoperative complications such as acid regurgitation,belching,sternal burning sensation significantly reduced in the observation group( P < 0. 05). Conclusion Preserving vagus trunks can significantly improve the prognosis of patients with early and middle esophageal cardiac cancer underwent radical surgery,reduce the incidence of postoperative complications,and effectively protect the digestive function after operation.

关 键 词：保留迷走神经干 食管贲门癌 疗效 预后 

分 类 号：R735.1[医药卫生—肿瘤]