实验性胃功能障碍与胃食管返流关系的猪仔模型研究

Relationship Between Experimental Gastric Dysfunction and Gastroesophageal Reflux in Newborn Pigs

目的 :探讨实验性猪仔胃功能障碍性因素与胃食管返流的关系。方法 :新生猪仔 40只 ,随机分成 5组 ,膈食管韧带切开、食管裂孔开大、胃壁部分浆肌层破坏、幽门十二指肠上段部分缝合闭锁造成不全梗阻等 4组猪仔模型及对照组 ,术前、术后行胃肠钡餐透视 ,食管测压。猪仔生长至 12 16周时处死 ,行大体解剖观察及病理学观察。结果 :对照组无返流发生 ;实验组出现不同程度的返流。结论 :胃排空障碍、胃 幽门 十二指肠蠕动不协调导致胃内压增高是造成胃食管返流的重要原因 ;小型食管裂孔疝伴有胃食管返流随着时间的延长有自愈的可能性 ;调整胃 幽门

Objective: Our aim was to investigate the relationship between experimental gastric dysfuncion and gastroesophageal reflux (GER). Methods: This experiment was carried out in 40 newborn pigs which were divided into 5 groups randomly. The control group was operated on abdomen only for detection; the first experimental group, with diaphragm esophageal ligment incised and His angle destroyed; the second, besides the above, with esophageal hiatus enlarged; the third, with partial seromuscular layer destroyed; the fourth,with partial obliteration of pylorium and upper part of duodenum. The newborn pigs were examined by using gastrointestinal x ray and esophageal pressure measurement before and after the operation, then were killed when 12 to 16 weeks old and specimens were obtained for further pathological studies. Results: The control group had no GER, while the animals in experimental groups were diagnosed as GER at different degrees. Conclusion: Occurance of GER has close relationship to delayed gastric emptying and incoordinated peristalsis of stomach pylorium duodenum. The rise of gastric pressure is the main cause of GER. The symptoms of small hernia of esophageal hiatus with GER may possibly recover automatically with the time. Coordinating peristalsis of stomach pylorium duodenum is the key to cure GER.