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目的 研究保留迷走神经的食管贲门癌切除术对术后生活质量的影响.方法 对39例无外侵的早中期食管贲门癌患者施行根治性切除中迷走神经保留术,并随机选取39例未保留迷走神经的常规手术作对照组.术后通过胃排空时间、血胃泌素含量测定、近期营养学计算来研究保留迷走神经的食管贲门癌切除术后胃肠消化功能.结果 保留组胃排空时间T1/2均数值20.3±8.9分和血胃泌素水平均数值34.2±18.5mg/L与对照组胃排空时间T1/2均数值35.7 ±5.8分和血胃泌素水平均数值56.5±21.6ng/L相比有显著差别,分别为P<0.01和P<0.05).术后近期营养学计算显示,保留组在术后短期内摄入量及营养状况达到正常,与对照组相比差异显著(P<0.05).结论 在早中期无周围外侵的食管贲门癌患者切除中保留迷走神经对于防止病人术后消化功能紊乱,提高生活质量有着重要的临床意义.
Objective To study the effect of vagal nerve-preserving esophageal and cardiac cancer resection on postoperative quality of life. Methods Radical resection and vagotomy were performed in 39 cases of early and mid-stage esophageal and cardiac cancers without external invasion. 39 cases were randomly selected without vagal nerve preservation. Conventional surgery was used as a control group. Gastric emptying time, serum gastrin content, and recent nutritional calculations were used to study gastrointestinal digestive function after esophageal and cardia cancer resection with preserved vagus nerve. Results Reserved group gastric emptying time T1/ 2 The mean value was 20.3±8.9 and the blood gastrin value was 34.2±18.5 mg/L. The mean value of gastric emptying time T1/2 was 35.7±5.8 in the control group and the mean value of blood gastrin was 56.5±21.6 ng/L. There was a significant difference in L (P<0.01 and P<0.05, respectively). Postoperative nutritional calculations in the immediate post-operative period showed that intake and nutritional status of the retained group were normal in the short-term postoperative period, which was significantly different from the control group ( P<0.05). Conclusions Preserving the vagus nerve in patients with esophageal and cardiac cancer without surrounding invasion during early and mid-term has important clinical significance for preventing postoperative digestive dysfunction and improving quality of life.