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食管癌切除术后胃窦幽门十二指肠运动的变化 被引量:12

Antropyloroduodenal motility after resection of esophageal cancer
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摘要 目的 通过监测食管癌切除术后患者消化间期胃窦、幽门、十二指肠移行性复合运动波(MMC)的变化 ,探讨胸部胃对固体食物排空延缓的发生机制。 方法 食管癌切除术后第 7~ 11天 ,通过 8通道袖套式测压导管监测患者胃窦、幽门、十二指肠的运动。 结果 幽门、十二指肠检出 2 8个MMC周期 ;胃窦检出 12个MMC周期 ,其中 4次MMCⅢ相活动后于十二指肠MMCⅢ活动的发生。MMC周期平均持续时间 :胃窦 (49 2± 10 5 )min ,幽门 (46 5± 10 4 )min ,十二指肠 (45 9± 10 0 )min ;MMCⅢ相平均持续时间 :胃窦 (6 7± 3 5 )min ,幽门 (10 0± 3 5 )min ,十二指肠 (8 0± 3 9)min。MMCⅢ相收缩波的平均振幅 :胃窦 (83± 30 )mmHg,幽门 (6 0± 12 )mmHg ,十二指肠 (5 5± 4 )mmHg。结论 胃窦MMCⅢ相活动次数及其收缩波平均振幅的减小 ,胃窦、幽门、十二指肠MMCⅢ时相的不协调运动是胸部胃对固体食物排空延缓的重要原因之一。 Objective To study the mechanism of delayed emptying indigestible solids in thoracic stomach after the resection of esophageal cancer by monitoring the variety of antropyloroduodenal migrating motor complex (MMC) during interdigestion. Methods Esophagectomy and gastroesophagostomy in the neck was performed in 5 men with esophageal cancer. An eight lumen manometric sleeve assembly was passed through a nostril into the duodenum during operation. The sleeve was astride the pylorus. Antropyloroduodenal manometry was performed for at least 300 min with a polygraphic system (PC POLYGRAF HR ) 7 11 days after operation. Results Twenty eight MMCs were recorded in the pylorus and duodenum, 12 MMC s in the antrum, and 33% (4/12) of the motility frequency of antral phases Ⅲ started after that of pyloroduodenal phases Ⅲ. The number of MMC in the antrum was lower than that in the duodenum after the operation. The mean duration of MMC of the antrum, pylorus and duodenum was (49 2±10 5 ) min, (46 5±10 4 ) min and (45 9±10 0) min respectively. The mean duration of phases Ⅲ was respectively (6 7±3 5) min in the antrum, (10 0±3 5) min in pylorus, and (8 0±3 9 ) min in duodenum. The mean wave amplitude of phases Ⅲ was respectively (83±30) mm Hg in the antrum, (60±12) mm Hg in pylorus, and (55±4) mm Hg in duodenum. The mean duration of MMC of the antrum and duodenum was shorter in patients than that in healthy volunteers, and the mean wave amplitude of phases Ⅲ of the antrum was lower in patients than that in healthy volunteers. Conclusions Diminution of the number of MMC and the mean wave amplitude of phases Ⅲ in the antrum, incoordination of the antropyloroduodenal phases Ⅲ should be the most important one of the mechanisms of delayed emptying of indigestible solids in thoracic stomach after the resection of esophageal cancer.
出处 《中华外科杂志》 CAS CSCD 北大核心 2002年第7期511-514,共4页 Chinese Journal of Surgery
关键词 食管癌 胃窦 幽门 十二指肠 胃肠活动 外科手术 Pyloric antrum Gastrointestinal motility Esophageal neoplasms Postoperative period
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  • 1Wang Qizhang,Chin Med J,1988年,101卷,485页

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