摘要
目的观察贲门癌对食管运动功能的影响以及手术后残余食管、残胃的运动功能改变。方法 用低顺应性三腔聚乙烯液压毛细管灌注导管对22例正常人和31例中晚期贲门癌患者进行了食管压力测定。所有受检者均仰卧位,每次吞咽5ml水,采用定点牵拉法。计算机自动计算出各部位的静息压、收缩压、收缩及松弛时间、传播速度。结果贲门癌患者手术前与正常人的各项指标(除下括约肌外)相比较,贲门癌患者食管下段收缩时间明显长于正常人。贲门癌患者手术前后的数据比较:①手术后上括约肌收缩压明显高于手术前。②手术后食管上段静息压和收缩压均明显高于手术前。③手术后食管中段收缩压明显低于手术前。④手术后胃的压力明显低于手术前。⑤手术后食管中段静息压明显低于胃的压力。结论①贲门癌这一疾病并未改变食管运动功能。②手术后近期吻合口处有一高压带,可起到阻止胃腔正压向食管腔传递的压力屏障作用。③手术使食管中段收缩运动功能减弱。④术后反射性引起食管上段收缩增强,从功能上讲似能阻止可能发生的食管咽返流。
ObjectiveTo explore the influence of cardiac cancer on esophageal motor function and the motor function of remains of esophagus and stomach. MethodsTwenty two healthy persons and 31 patients with cardiac cancer were studied with a low compliance three lumen polyvinyl capillary infusion catheter.All the subjects were given 5 ml water with each swallow in the supine position and studied by station pull through the method.The resting and contracting pressure,duration of contraction and relaxation,velocity at various sites were calculated automatically by computer.ResultsBefore operation,the lower esophageal contractile duration of the patients with cardiac cancer was longer than that of health persons.Comparison between pre and postoperative data showed that:①Contracting pressure of upper esophageal sphincter(UES) was significantly increased after operation.②Both resting and contracting pressures of upper esophagus were increased postoperatively.③Contracting pressure of middle esophagus was significantly decreased after operation.④Gastric pressure was decreased postopereatively.⑤Postopereatively resting pressure of middle esophagus was lower than that of stomach.ConclusionThe disease,cardiac cancer in middle and advanced stage, didn't alter esophageal motor function. A high pressure zone was formed at the site of anastomosis in short term after operation,which can be prevented from gastric positive pressure transiting to esophageal lumen. Contraction of middle esophagus was decreased after operation, but upper esophageal function was increased compensatively. Contraction of UES was increased reflexly, it seems to prevent from esophago pharyngeal reflux.
出处
《河北医科大学学报》
CAS
2000年第2期75-77,共3页
Journal of Hebei Medical University
关键词
贲门癌
围手术期
上消化道动力学
cardia/surg
intraoperative period
digestive system/surg
kinetics
