摘要
目的观察保留完整的胸胃在未附加幽门引流术的情况下,对半固体食物的排空过程,探讨完整胸胃的排空规律。方法20例胸段食管癌病人分2组,近期术后组(12例)和远期术后组(8例),另设对照组(健康成年人10例)。观察不同时期病人,在进食试餐后120min内不同时间点的胃排空率(GER)和0～30min及30～120min的胃排空速率(GEV),并进行组间比较。结果近期术后病人的GER与术前相比,餐后5～100min明显快于术前(P<0.05);120minGER无差别(P>0.05);近期术后病人餐后GEV:0～30min加快而30～120min延迟,两个时间段的GEV比较差别显著(P<0.001);远期术后与近期术后病人的GER各时间点比较无显著性差异(P>0.05)。结论食管癌近期术后大部分病人的胸胃对半固体食物排空呈双相,但120min总排空率与术前相比无差别;远期术后病人胸胃对半固体食物的排空与近期术后无差别,食管癌病人手术时不需要常规附加幽门引流术。
Objective To investigate the gastric emptying of patients who had the whole stomach left and without pyloric drainage after esophagectomy. Methods 30 subjects were involved. 20 patients were divided into 2 groups, Group A： 12 cases who had esophageal cancer without disturb intrathoracic gastric emptying and postoperative time was less than one month. Group B： 8 cases with postoperative time was more than 6 month; 10 health subjects as Group C without any affecting or digestive functional diseases. Each subject took semisolid meal, and then calculated the gastric emptying rate （GER） of different time in 120min, also the gastric emptying velocity （GEV） of 0-30min and 30-120min. Results Compared with pre-operation, GER of 12 short-term postoperative cases significantly increased in 5 to 100 min （P〈0.05）, but no difference at 120 min （P〉 0.05）. The intrathoracie stomach can be divided into quick phase in 0-30 min and lag phase in 30-120 min of postprandial time in 12 short-term postoperative patients, there was significant difference of GEV between two phases （P〈0.001）. Compared to that of pre-operative patients, the GEV accelerated in 0-30 min （P〈O.001） but delayed in 30-120 min （P〈0.001） of postprandial time. There was no difference of intrathoracic gastric emptying was found between long-term and short-term postoperative patients （P〉0.05）. Conclusion The gastric emptying of the intrathoracic stomach for semisolid meal appeared two phases： quick phase in 0-30min and lag phase in 30-120min of postprandial time in most short-term postoperative patients. Compared with pre-operative patients, the GER at 120 min was no difference. There no difference of GER at each postprandial time point was found between long-term and short-term cases after esophagectomy. It suggests that the pyloric drainage is unnecessary for patients with intrathoracic stomach.
出处
《中国现代医药杂志》
2005年第5期44-47,共4页
Modern Medicine Journal of China
