摘要
目的探讨幽门括约肌捏断对食管癌切除胃食管高位吻合术后胃排空功能的影响。方法对28例食管癌切除高位胃食管吻合患者附加幽门括约肌捏断,监测幽门压和胃排空功能。结果幽门括约肌捏断前幽门收缩压(86.56±9.61)mmHg非常显著高于基线收缩压(43.37±4.64)mmHg(P<0.01),捏断后收缩压(29.96±3.37)mmHg非常显著低于基线收缩压(P<0.01),而幽门静息压在捏断前、后与基线静息压无显著差异(P>0.05);幽门括约肌捏断组半量胃排空时间与正常对照组无显著差异(P>0.05),而未捏断组较正常对照组、捏断组非常显著延长(P<0.01)。结论食管癌切除胃食管高位吻合术后,幽门压力升高,胃排空延缓,幽门括约肌捏断能有效促进胃排空,是一种预防胃排空障碍简便易行的方法。
Objective To explore the value of disconnection of pyloric sphincter （DPS） by finger pressing in thoracic gastric emptying function after esophageal carcinoma resection with high-level esophagogastrostomy. Methods Twenty-eight patients underwent esophageal carcinoma resection with high-level esophagogastrostomy combined with DPS. Intraoperative pyloric manometric studies were performed before vagotomy, before and after DPS. Radionuclide gastric emptying was carried out after operation. Results Pyloric contracting pressure （PCP） were significantly decreased after DPS [ （86.56 ± 9.61 ） mmHg vs （29.96 ± 3.37 mmHg） ] （ P 〈 0. 01 ）. In comparison with base line pressure [ （43.37 ±4.64） mmHg], PCP was increased before DPS （P 〈 0. 01 ） and decreased after the procedure （P 〈0.01 ）. Pyloric resting pressure （PRP） did not show significant difference between base line pressure before and after DPS. The thoracic stomach gastric emptying time, evidenced by emptying half radioactive contents, was longer in the patients without DPS than those undergoing DPS and in normal group （P 〈0.01 ）, but no significant difference was between the patients with DPS and normals. Conclusion The emptying of thoracic stomach after esophageal carcinoma resection with high-level esophagogastrostomy is delayed because of the increase of emptying resistance. Esophageal carcinoma resection with high-level obviously Key esophagogastrostomy with DPS can effectively improve gastric empting, so DPS by finger pressing is a convenient procedure to prevent postoperative delayed gastric empting.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2006年第6期601-602,共2页
Journal of Third Military Medical University
