管状胃加胃底重建食管癌术后胃食管反流的临床研究

目的探讨研究管状胃加胃底重建减压食管癌术后胃食管反流的临床效果。方法选取我院63例符合条件、患有食管癌且需进行手术的患者,并将其分为观察组33例和对照组30例。观察组患者采用管状胃加胃底重建减压食管癌术进行治疗,对照组患者只采用管状胃手术进行治疗。对两种治疗方法进行临床观察。结果两组患者在手术完成之后均存在一定的胃食管反流情况。与对照组相比,观察组的24 h酸反流次数、最长持续反流时间、pH值<4的总时间、以及pH值<4占总检测时间的百分比均较低(P<0.05)。在治疗完成1年后对两组患者的不良反应进行对比研究,结果发现患者发生的不良反应主要为食管炎症、糜烂、溃疡、以及吻合口异常,且两组患者在不良反应及并发症发生方面差异无统计学意义(P>0.05)。结论采用管状胃加胃底重建减压食管癌术的疗效优于单纯的管状胃手术,值得临床推广。

Clinical outcomes of esophageal reconstruction with tube-shaped stomach and reconstruction of gastric fundus in attenuating gastroesophageal reflux in patients underwent resection of esophageal carcinoma

Objective To find out the clinical outcomes of esophageal reconstruction with tube-shaped stomach and recon struction of gastric fundus in attenuating gastroesophageal reflux in patients underwent resection of esophageal carcinoma.Methods 63 patients with esophageal carcinoma were chosed and divided into observed group（33 cases） and control group（30 cases）.Patients in observed group received the treatment of esophageal reconstruction with tube-shaped stomach and reconstruction of gastric fundus diagnose,while others received the treatment of esophageal reconstruction with tube shaped stomach.The two treatments were observed.Results There were attenuating gastroesophageal reflux in both groups.Compared with the control group,the frequency of regurgitation of gastric juice during 24 h period,the longest time of re flux,total time with pH 4 and percentage of total time with pH 4 were significantly lower（P〈0.05） in the observed group.The most common complications 1 year later were esophageal inflammation,erosion,ulcers and anastomotic abnor malities,and there were no significant difference between the two groups（P〉0.05）.Conclusion Esophageal reconstruction with tube-shaped stomach and reconstruction of gastric fundus in attenuating gastroesophageal reflux in patients underwent resection of esophageal carcinoma is better than esophageal reconstruction with tube-shaped stomach only.