贲门癌术后近期24小时食管pH监测

为了解贲门癌切除术后患者胃食管反流的具体情况,探讨现行手术方法对胃食管反流的影响,评价体位改变对减少胃食管反流的效果,作者对３０例贲门癌患者在术后１３～１８天进行了２４小时食管ｐＨ监测。结果显示：（１）贲门癌患者术后２４小时食管ｐＨ各项监测指标均高于正常（Ｐ＜０．０１）,但只有６０％的患者有典型胃食管反流症状;（２）胸内吻合与腹内吻合、套入式吻合与围巾式吻合相比,监测结果无显著差别（Ｐ＞０．０５）;（３）术后上身抬高３０°仰卧的患者,监测指标均明显低于对照组（Ｐ＜０．０１）。由此得出结论：（１）贲门癌患者术后普遍存在胃食管反流;（２）上身抬高可明显减少胃食管反流;（３）目前常用的一些手术吻合方法不能减少胃食管反流;（４）尽管某些患者没有反流的典型症状,胃食管反流仍存在。

24 hour esophageal pH monitoring in patients with cardiac cancer postoperatively

Twenty-four-hour esophageal pH monitoring was performed in thirty patients with cardiac cancer on the 13rd to 18th postoperative day in order to understand the condition of gastroesophageal reflux (GER), the value of commonly used operative procedures and the effect of patients sleeping position for preventing GER. GER parameters were higher than those of normal subjects (P < 0.001), but there were only 60% patients who had typical GER symptoms. No significant differences were found between anastomoses in abdomen and chest, encasing-in style, and "scarf" style (P > 0.05). Patients sleeping with upper body raised for 30 degrees had much lower GER parameters than those of controls. Manual anastomosis often used now couldn't decrease GER. All patients with cardiac cancer have postoperative GER though they had no typical symptoms of GER, but GER was avoided during sleeping with upper body erected.