先天性上消化道梗阻患儿手术前后胃食管测压研究

The Manometric Study of Stomach and Esophagus in Preoperative and Postoperative Stage of the Patients of Congenital Upper G astrolntestinal Ohstruction

对４６例光天性肥厚性幽门狭窄（ＣＨＰＳ）和１８例先天性十二指肠梗阻患儿进行胃、食管测压，以探讨上消化道梗阻对食管下端括约肌（ＬＥＳ）功能的影响，结果：两者术前均有ＬＥＳ功能损害，十二指肠梗阻患儿改变更明显；术后７～１０ｄ均有明显恢复，但十二指肠梗阻患儿仍未完全恢复正常。同时，还观察到ＬＥＳ功能损害与发病年龄、病史及呕吐症状轻重有关。将十二指肠梗阻患儿与ＣＨＰＳ患儿的测压结果进行比较可见：前者ＬＥＳ压力明显低于后者，ＬＥＳ高压区长度在十二指肠梗阻时升段和降段长度均有改变，而ＣＨＰＳ患儿只是升段有改变，使ＬＥＳ有效长度缩短，提示胆汁与胃酸混合后比单独胃内容物对食管损害严重。

o evaluate the effect of upper gastrointestinal obstruction on LES function,we performed themanometry study of 46 cases with CHPS and 18 cases with congenital duodenal obstruction. The studyshowed that during preoperative stage,the LES function was damaged in different degrees in all cases,specially in the patients with congenital duodenal obstruction. After 7～10 days of operation all of theindices were recovered,but the recovery was still incomplete in the patients of duodenal obstructionsignificantly patients. At the same time we also observed that the recovery of the function of LES de- pended on the length of case history,the age of the patients and the condition of vomiting. The compar- ision of manometric study between congenital duodenal obstruction and CHPS patients showed that theLES pressure of duodenal obstruction were significantly lower than that of CHPS,the length of LESwas changed both in the ascending and descending part of high pressre zorie. But in the patients of CH-PS the changes were only in the ascending part of high pressure zone that reduce the effective length atLES, which suggested that the mixing of bile and the stomach substances caused more severe damage onesophagus than the only stomach substance.