胃癌切除术后食管蠕动情况及胃肠激素水平变化的临床研究

Clinical study of esophageal peristalsis and changes of gastrointestinal hormones in patients with gastric cancer after resection

目的探讨胃癌切除术后食管蠕动情况及胃肠激素水平的变化情况。方法选择24例行远端大部切除术的胃癌患者为研究组,选择25例健康志愿者为对照组,比较两组研究对象的食管动力学指标及胃肠激素水平。结果研究组患者术前食管下括约肌静息压低于对照组(P﹤0.05),术后1个月食管下括约肌静息压低于术前及对照组(P﹤0.05);研究组患者术后3个月食管体部蠕动远端收缩积分、食管体部蠕动收缩前沿速度、食管下括约肌静息压、食管完整松弛压力均低于术后1个月、术前及对照组(P﹤0.05)。研究组患者术前胃动素水平高于对照组,胃促生长素水平低于对照组,差异均有统计学意义(P﹤0.05);研究组患者术后1周和术后3个月胃动素、胃促生长素、瘦素水平均低于术前及对照组,差异有统计学意义(P﹤0.05);研究组患者术后3个月胃动素水平高于术后1周,胃促生长素水平低于术后1周,差异均有统计学意义(P﹤0.05)。结论胃癌切除术后患者的食管动力学指标和胃肠激素水平均有不同程度的下降,两者具有一定的关联。

Objective To observe the esophageal peristalsis and gastrointestinal hormones in gastric cancer patients after surgery. Method 24 cases of gastric cancer patients who were administered with distal subtotal gastrectomy were included as study group, meanwhile, 25 cases of healthy volunteers were recruited as control group. The esophageal dynamics and the levels of gastrointestinal hormones were compared between the two groups. Result The resting pressure of lower esophageal sphincter（LES） in study group before surgery was significantly lower than that in control group, the difference was statistically significant（P〈0.05）; besides, the resting pressure of LES of study group in 1 month after surgery was also lower than that in control group, with statistically significant difference observed（P〈0.05）; in 3 months after surgery, the distal contractile integral（DCI） and contractile front speed of esophageal body, resting pressure of LES,complete relaxation pressure of esophagus were all significantly lower as compared with that in 1 month after surgery, before surgery and in control group, demonstrating significant difference（P〈0.05）. The study group had higher level of motilin, while lower ghrelin than in control group（P〈0.05）; while in 1 week and 3 months after surgery, the level of motilin,ghrelin, and leptin were significantly lower than that before surgery and in control group, all showed significant difference（P〈0.05）; the motilin level in 3 months after surgery was higher than that in 1 week after surgery, and ghrelin was also lower in 1 week after surgery, the difference was statistically significant（P〈0.05）. Conclusion The esophageal dynamics and gastrointestinal hormones in gastric cancer patients after surgery were decreased inconsistently, indicating underlying association.