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食管粘膜胃全层吻合 贲门成形术后抗胃食管返流功能的临床流行病学研究 |
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原和平 郭石平 丁 悌 冯守山
摘要 作者设计并在临床上开展了一种新的手术方法以预防食管贲门癌手术后的胃食管返流。1994年4月～1995年12月随机抽取34例作实验研究组，同期使用吻合器吻合的27例为对照组，术后进行了观察、监测和随访。研究组病例无胃食管返流症状，食管镜检查、钡餐造影无明显返流。对照组中10例病人(37.0%)伴有烧心、返酸等症状，食管镜下、钡餐X线检查有炎症和明显的胃食管返流。研究组和对照组吻合口近测pH的标准差依次为7.0249±0.9996、4.6667±2.4573，经t检验两者差异有非常显著性(P<0.01)。作者强调手术方法的改进是预防食管、贲门癌术后胃食管返流的关键。
关键词 食管肿瘤 贲门肿瘤/外科手术 胃食管返流
Clinical Epidemiologal Research of Antigastroesophageal Reflux after Cardiacplasty by Anastomosis of Esophageal Mucosa and Gastric Wall Yuan Heping,Guo Shiping,Ding Ti,et al. Shanxi Tumor Hospital,Taiyuan 030013
Abstract A new operative method was designed for preventing gastroesophageal reflux after esophageal and cardiac cancer operation.From April,1994 to December,1995,sixty-one patients after resection of esophageal and cardiac cancer were randomly divided into two groups:experimental group with 34 patients and control group with the others.All patients were observed,monitored and followed up.It was found that no case in the experimental group showed symptoms of gastroesophageal reflux or marked reflux by esophagoscopy and barium meal examination.10 patients (37%) in the control group had the symptoms of heartburn and regurgitation and inflammation and obvious gastroesphageal reflux were observed under esophagoscopy and barium meal examination.The pH values of anastomotic ostium were 7.0249±0.9996 and 4.6667±2.4573 in the experimental and control groups,respectively.Significant difference (P<0.01) was observed between two groups with t test.The results showed that the advancement of operative method plays a key rolein prevention of gastroesophageal reflux.
Key words Esophageal carcinoma Cardiac carcinoma/gastroesophageal reflux Surgical operation
我国是世界上食管癌贲门癌的高发地。随着多年来食管、贲门癌手术治疗的广泛开展，作为手术切除后三大并发症之一的胃食管返流已引起一些外科工作者的严重关注。近年来，作者通过对正常胃食管连接区抗返流功能的研究，设计并在临床上开展了食管粘膜胃全层吻合——贲门成形术。1994年4月～1995年12月，我们对61例病人进行了随机对照分组研究，以探讨这种新的手[1] [2] 下一页
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