摘要
目的观察贲门癌术后残胃排空功能变化,探讨改善病人术后生活质量的方法。方法用豆奶粉40g,水200mL,加入185MBq99TcmDTPA,制成试验餐,于术后18~20d对25例行贲门癌近端胃次全切除患者[附加幽门括约肌捏断17例(A组),单纯近端胃次全切除8例(B组)]和5例健康人(N组)进行核素胃排空检查。结果口服试验餐后105min之内,每一时刻的胃排空率B组均低于A组(P均<001)和N组(P均<005),而A组与N组差异无显著性(P均>005)。B组的半量胃排空时间为(615±70)min,较A组(256±56)min(P=00013)和N组(336±61)min(P=0026)明显延长,而A组的半量胃排空时间与N组差异无显著性(P>005)。结论贲门癌行近端胃次全切除术后,残胃排空延缓,若附加幽门括约肌捏断术,则明显加快残胃排空,改善术后症状。
Objective To assess emptying of the remaining stomach after proximalsubtotal gastrectomy for cardiac cancer, and to explore a method improving the life quality of postoperative patients Methods Radionuclide gastric emptying test was performed on 17 patients who underwent proximal subtotal gastrectomy plus disruption of pyloric sphincter (PSG+DPS) by manipulative nipping and on 8 patients who underwent proximal subtotal gastrectomy (PSG) only 18 to 20 d before, and on 5 normal controls Test meal was prepared from the mixture of soybean milk powder (40 g), water (200 mL) and 99 TcmDTPA (185 MBq) as a tracer Results During the first 105 min after ingestion of test meal, gastric emptying rate at each time was lower in PSG group than those in PSG+DPS group ( P <001) and normal controls ( P <005) However, the gastric emptying rate did not show significant difference between PSG+DPS group and normal controls ( P >005) The time required for the stomach to empty half of its radioactive content (T1/2) was longer in the patients who had PSG only than that in those who underwent PSG+DPS , ( P =00013) and normal controls 3661) min], ( P =0026) However, there was no significant difference regarding T1/2 between the patients with PSG+DPS and normal controls ( P >005) Conclusions Proximal subtotal gastrectomy inevitably delays the emptying of remaining stomach, and DPS can effectively accelerate its emptying and improve postoperative symptoms
出处
《中华核医学杂志》
CAS
CSCD
北大核心
1999年第3期137-138,共2页
Chinese Journal of Nuclear Medicine