食管癌术后残余食管和胸腔胃运动功能对胃食管反流的影响

Influence of motility of the remnainder esophagus and intrathoracic stomach on gastroesophageal reflux in patients with esophagus cancer after esophagectomy

目的探讨食管癌术后残余食管和胸腔胃运动功能改变对胃食管反流的影响。方法定期对食管中段癌术后患者46例(A组)进行食管测压、显示子胃排空和24-h食管pH监测,结果与健康志愿者11例(B组)作比较。结果 A组手术后和术后12个月残余食管和胸腔胃运动功能均低于B组(P<0.01和P<0.05)。A组胸胃排空率与DeMeester评分之间以及长于5min反流评分与残余食管原发蠕动幅度、蠕动次数之间均无相关关系(P>0.05)。结论食管癌术后胸腔胃和残余食管运动功能的恢复不足以减轻胃食管反流以及改善食管酸清除功能。

Objective To investigate the effect of motility of the remnainder esophagus and intrathoracic stomach on gastroesphageal reflux after surgery for esophagus cancer. Methods The examinations of esophageal pressure, 24-h esophageal pH and gastric emptying were periodically performed in 46 patients with esophagus cancer after esophagectomy（group A）. The results were compared to those in 11 healthy persons（group B）. Results The motility of the remnainder esophagus and intrathoracic stomach in early stage and 12 months after surgery was significantly lower in group A than that in group B（P〈0. 01 and P〈0. 05）. There was no correlation between DeMeester score and gastric emptying, so did between the reflux score of episodes longer than 5 minutes and the primary peristaltic amplitude and number in the remnainder esophagus （P〉0. 05）. Conclusion The recovery of motility of intrathoracic stomach and remnainder esophagus is not sufficient enouph to reduce the extent of gastroesophageal reflux and improve the capacity of esophageal acid clearing.