黏膜瓣式食管胃吻合术抗反流的食管动力学研究

目的寻找一种实用有效的抗反流食管胃吻合术式。方法将食管癌和贲门癌患者464例随机分为黏膜瓣式食管胃吻合术组(A组,175例)、器械食管胃吻合术组(B组,151例)和单纯手工缝合食管胃一层吻合术组(C组,138例)。应用同位素测定胃食管反流指数和24h监测pH值,进行3组间的食管运动功能比较。结果同位素测定胃食管反流指数显示,A组反流阳性率为0,B组为33.3%,C组为6.7%。食管运动功能及24h监测pH显示,A组检测各项指标均接近正常值,B、C组与正常值比较,差异具有统计学意义(P<0.05)。结论黏膜瓣式食管胃吻合术式具有优异的抗反流功能,并能有效地防止食管癌、贲门癌术后反流性食管炎的发生。

Study on esophageal motor function against reflux after esophagogastric anatomosis with mucosal valve

Objective To find an effective operative procedure against reflu x after esophagogastric anatomosis with mucosal valve. Methods Four hundred and si xty four patients with esophageal or cardiac cancer were randomly divided into three groups according to anastomosis modes. Group A underwent esophagogastric a natomosis with mucosal valve(175 cases),group B with mechanical stapler(151 case s) and group C one layer anastomosis with handcraft suture(138 cases). The gastr oesopheal reflux index (GERI) was examined by isotope,and 24 h esophageal pH was also monitored. The esophageal motor function was compared among three groups. Results The reflux rates were 0,33.3%,and 6.7%in group A,B,C,respectively. T he esophageal motor function and the 24 h esophageal pH monitoring indicated tha t the various indexes were approaching to the normal level in group A,but the va rious indexes in group B and C were significantly different from the normal valu es (P< 0.05). Conclusion The esophagogastric anatomosis with mucosal valve has b etter antireflux effect and can prevent the reflux esophagitis after esophageal or cardiac cancer eradication.