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食管纵隔胃颈部吻合术后食管胃的压力监测及评价 预览 被引量:9

Manometric study of residual esophagus and stomach after subtotal esophageal resection and cervical gastroesophagostomy
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摘要 目的检测食管癌切除食管、纵隔胃颈部吻合术后病人残余食管及胃的功能。方法采用国产SG-Ⅲ型消化道压力检测仪对21例食管癌切除食管纵隔胃颈部吻合术后病人进行消化道压力检测,并与25名正常人测定值对照。结果术后病人咽部的静息压力为(1.20±2.03)mmHg(1mmHg=0.133kPa),收缩压为(72.37±16.95)mmHg;食管上括约肌的静息压力为(28.20±15.60)mmHg,关闭压为(107.10±28.43)mmHg;吻合121上方食管的静息压力为(15.98±11.10)mmHg,收缩压为(48.45±18.37)mmHg;胃的静息压力(3.53±3.30)mmHg,食管原发性蠕动的发生率为(57.14土34.50)%。其中吻合121上方食管的静息压力值明显高于正常成人(5.63±8.78)mmHg,差异有统计学意义(P〈0.01)。结论食管癌切除食管胃颈部吻合术后,在吻合口上方的食管产生了新的压力区。该压力的形成与吻合时胃上提包套残余食管及颈部肌群等软组织共同对食管所造成的压力有关,具有一定的抗反流作用,食管胃颈部吻合的术式具有更好的减轻术后胃食管反流的作用,能改善病人术后生活质量。 Objective To evaluate the function of residual esophagus and stomach after subtotal esophagectomy and cervical gastroesophagostomy for esophageal eareinoma. Methods Manometry was performed in 21 patients who underwent cervical anastomosis after subtotal esophageal resection. The data was compared with normal subjects. Results The mean value d pharyngeal resting Pressure was (1.20±2.03)mm Hg(1 mmHg=0.133 kPa), and that of contraction pressure was (72.37± 16.95) mmHg. The resting pressure of upper esophageal sphincter (UES) was (28.20± 15.60) mmHg, and dosing pressure was ( 107.10± 28.43) mmHg. The resting pressure of residual esophagus was (15.98± 11.10)mmHg, and contraction pressure was (48.45±18.37)mmHg. The resting pressure of stomach was (3.53±3.30)mmHg. Incidence of primary wave of esophagus was (57.14±34.50)%. The resting pressure of residual esophagus was much higher thaa that of normal normal group (p〈0.01). Conclusion Manometric study showed that thereisa new pressure zone in the residual esophagus. This pressure zone decreased gastroesophageal reflux and improved postoperative symptoms and quality of life. The formation of this pressure zone is correlated with invagnation of stomach and pressing of soft tissue of neck to residual esophagus after subtotal esophagectomy combined with cervical anastomosis.
作者 陈明耀 邵令方 高宗人 务森 CHEN Ming-yao, SHAO Ling-fang, GAO Zong-ren, et al.( Department of Thoracic Surgery, Henan Tumor Hospital, Zhengzhou 450003, China)
出处 《中华胸心血管外科杂志》 CSCD 北大核心 2006年第6期 399-400,共2页 Chinese Journal of Thoracic and Cardiovascular Surgery
关键词 食管肿瘤 吻合术 外科 胃食管反流 Esophageal neoplasms Anastomosis,surgical Gastroesophageal reflux
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参考文献4

  • 1陈明耀,务森.正常成人食管运动功能的检测研究[J].河南医学研究,1997,6(4):310-311. 被引量:1
  • 2王其彰 张毓德 等.食管癌切除后胃重建食管的测压观察[J].中华外科杂志,1988,26(5):305-305. 被引量:24
  • 3De Leyn P,Coosemans W,Lerut T.Early and late functional results in patients with intrathoracic gastric replacement after oesophagectomy for carcinoma.Eur J Cardiothorac Surg,1992,6:79-84. 被引量:1
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