生物胶胸腔胃纵隔食管床内固定法的临床应用研究

目的应用生物胶将胸胃固定于纵隔食管床内,以减小胸胃的容积,改善患者术后肺功能。方法203例食管癌手术食管胃弓上吻合者随机分为观察组（A组）和对照组（B组）,分别测定术前、术后3、10、30 d肺功能,比较2组胸胃对肺功能的影响。术后10 d、30 d、3个月吞稀钡胃造影,测定胸胃正面最大宽径及胃的蠕动次数,判定胸胃固定效果和对胃蠕动的影响。结果VC、MVV术后10 d、30 d 2组肺功能及术后10 d,30 d和3个月胸胃最大宽径2组对比差异有统计学意义（P〈0.01）。结论生物胶胸胃纵隔食管床内固定法可有效减轻术后胸胃对呼吸的影响,操作简便,固定可靠。

Clinical study on the application of intrathoracic stomach fixation in esophageal bed with biological glue

Objective The application of intrathoracic stomach fixation in esophageal bed with biological glue in order to decrease volume of intrathoracic stomach and improve pulmonary function of patients after operation. Methods 203 patients underwent the operation of esophageal carcinoma and esophagogastrostomy above the aortic arch were randomly divided into observation group and control group. Patients＇ pulmonary function was measured respectively before operation, on the 3 th, 10 th, 30 th day after operation. The Influence of intrathoracic stomach on pulmonary function was compared between the two groups. Barium examination of stomach was performed on the 10 th, 30 th days and three months after operation. The obverse width-radius of intrathoracic stomach and peristaltic times of stomach were measured. The effect of fixation of intrathoracic stomach and the effect of stomach peristalsis were evaluated. Results There were significant differences in VC percentage and MVV percentage between the two groups （ P 〈 0.01 ）. On the 10 th, 30 th day after operation, there was a significant difference in lung function and width of intrathoracic stomach between two groups （ P 〈 0.01 ） . Conclusion The application of intrathoracic stomach fixation in esophageal bed with biological glue can effectively relieve the influence of intrathoracic stomach on respiratory function after operation, and the method is simple and fixation is reliable.