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

Clinical Epidemiologal Research of Antigastroesophageal Reflux after Cardiacplasty by Anastomosis of Esophageal Mucosa and Gastric Wall

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 2 7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 p H的标准差依次为 7.0 2 4 9± 0 .9996、4 .6667± 2 .4 573,经 t检验两者差异有非常显著性 ( P<0 .0 1)。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。

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 with34 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 p H values of anastomotic ostium were7.0 2 4 9± 0 .9996and4 .6667± 2 .4 573 in the experimental and control groups,respectively.Significant difference( P<0 .0 1) 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.