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目的检测食管癌切除食管、纵隔胃颈部吻合术后病人残余食管及胃的功能。方法采用国产SG-III型消化道压力检测仪对21例食管癌切除食管纵隔胃颈部吻合术后病人进行消化道压力检测,并与25名正常人测定值对照。结果术后病人咽部的静息压力为(1·20±2·03)mmHg(1mmHg=0·133kPa),收缩压为(72·37±16·95)mmHg;食管上括约肌的静息压力为(28·20±15·60)mmHg,关闭压为(107·10±28·43)mmHg;吻合口上方食管的静息压力为(15·98±11·10)mmHg,收缩压为(48·45±18·37)mmHg;胃的静息压力(3·53±3·30)mmHg,食管原发性蠕动的发生率为(57·14±34·50)%。其中吻合口上方食管的静息压力值明显高于正常成人(5·63±8·78)mmHg,差异有统计学意义(P<0·01)。结论食管癌切除食管胃颈部吻合术后,在吻合口上方的食管产生了新的压力区。该压力的形成与吻合时胃上提包套残余食管及颈部肌群等软组织共同对食管所造成的压力有关,具有一定的抗反流作用,食管胃颈部吻合的术式具有更好的减轻术后胃食管反流的作用,能改善病人术后生活质量。
Objective To detect the function of residual esophagus and stomach after resection of esophagus and mediastinum anastomosis in patients with esophageal cancer. Methods Twenty-one patients with esophageal resection of esophageal mediastinal anastomosis after gastroesophageal anastomosis were treated with domestic SG-III type digestive tract pressure detector. The gastrointestinal tract pressure was measured and compared with that of 25 normal subjects. Results The resting pressure of pharynx in postoperative patients was (1.20 ± 2.03) mmHg (1 mmHg = 0.133 kPa) and the systolic pressure was (72.37 ± 16.95) mmHg. The resting pressure of upper esophageal sphincter (28 · 20 ± 15 · 60) mmHg, and the closure pressure was (107 · 10 ± 28 · 43) mmHg. The resting pressure of esophagus above the anastomosis was (15 · 98 ± 11 · 10) mmHg and the systolic pressure was 48 · 45 ± 18 · 37) mmHg; resting pressure of stomach (3.53 ± 3.30) mmHg, and primary esophageal peristalsis (57 · 14 ± 34 · 50)%. The resting pressure value of the esophagus above the anastomosis was significantly higher than that of the normal adult (5 · 63 ± 8 · 78) mmHg, the difference was statistically significant (P <0.01). Conclusion Esophageal resection of esophagogastric anastomosis, the esophagus above the anastomosis produced a new pressure zone. The formation of pressure and gastric anastomosis when the residual esophageal neck and neck muscles and other soft tissue together on the esophageal pressure caused by a certain anti-reflux effect, esophageal and gastric anastomosis surgery has a better reduction Postoperative gastroesophageal reflux can improve postoperative quality of life.