管状胃宽度与食管癌术后抗胃食管反流的临床研究

Clinical research of stomach tube width and gastroesophageal reflux after esophagectomy for esophageal cancer

目的：总结采用管状胃的食管癌手术患者的术后反流情况，探讨管状胃宽度对食管癌切除术后胃食管反流的影响。方法前瞻性地按照入院顺序，将60例食管癌术中采用管状胃代食管的患者按管状胃裁制宽度是否大于3 cm，随机分为 A 组30例（管状胃宽度≥3 cm）和 B 组30例（管状胃宽度＜3 cm），分别在术后11～14 d 胃肠功能恢复后使用 pH 监测仪进行24 h 食管 pH 值监测。结果A组反流次数、反流超过5 min 的次数、pH 值＜4．00的总时间和最长反流时间均多于 B 组（t ＝2．735，P＝0．012；t＝4．502，P ＝0．001；t＝3．435，P ＝0．023；t＝4．286，P ＝0．002）。结论管状胃宽度影响反流的发生，细的管状胃可减轻食管癌术后反流的发生。

Objective To summarize the conditions of reflux after esophagectomy for esophageal cancer using stomach tube and investigate the influence of stomach tube width on reflux after esophagectomy for esophageal cancer.Methods According to the order of admission60 patientsundergoing esophagectomy for esophageal cancer using stomach tube were randomly divided into group Astomach tube width ≥ 3 cm30 cases and group Bstomach tube width 〈3 cm30 cases.Eleven to fourteen days after recovery of intestinal function24 h esophageal pH monitoring was conducted.Results The times of refluxtimes of reflux 〉5 mintime of pH〈4.00 and longest reflux time in group A were significantly larger or longer than those in group Bt=2.735P =0.012t=4.502P =0.001t=3.435P =0.023t=4.286P = 0.002.Conclusions Stomach tube width may influence the occurrence of refluxand thin stomachtube can reduce the reflux after esophagectomy for esophageal cancer.