摘要
目的探讨近端胃切除食管胃前壁吻合加幽门成形术预防反流性食管炎的临床效果。方法将46例患者随机分为2组:治疗组27例行食管胃前壁吻合加幽门成形术;对照组19例行食管胃后壁吻合。术后随访6个月,比较并分析2组术后上消化道钡餐检查钡剂反流入食管,胃镜示反流性食管炎,吻合口出血、狭窄、瘘及术后上腹部疼痛、烧心及反酸等并发症的差异。结果治疗组与对照组比较,上消化道钡餐检查钡剂反流入食管,胃镜示反流性食管炎及术后上腹部疼痛、烧心及反酸等并发症明显降低,差异有统计学意义(P<0.05)。两组患者均未出现吻合口出血、狭窄及瘘。结论近端胃切除食管胃前壁吻合加幽门成形术能明显降低患者术后反流性食管炎及上腹疼痛、烧心及反酸等并发症,值得临床推广应用。
【Objective】 To explore the clinical effects of prevention of reflux esophagitis by anastomosis of esophagus with front wall of stomach and pylorplasty after proximal gastrectomy. 【Methods】 A total of 46 patients were randomly separated into two groups： 27 patients in treatment group were performed anastomosis of esophagus with the front wall of stomach and reconstruction of gastric fundus, while 19 patients in control group were treated with esophago-gastric anastomosis built on the back wall of the stomach. Six months after the surgery, the following complications were compared between the two groups： barium reflux into esophagus in the process of barium inspection for upper gastrointestinal tract; reflux esophagitis verified by gastroscopy;anastomotic hemorrhage, stenosis and fistula; epigastralgia; heartburn and sour regurgitation after the surgery.【Results】 Compared with the control group, there were lower rates of barium reflux into esophagus in the process of barium inspection for upper gastrointestinal tract, reflux esophagitis, epigastralgia, heartburn and sour regurgitation in the treatment group after surgery（P〈0.05）. No patients in either group suffered from anastomotic hemorrhage, stenosis or fistula. 【Conclusion】 The anastomosis of esophagus with the front wall of stomach and pylorplasty after proximal gastrectomy could significantly decrease the complications as reflux esophagitis, epigastralgia, heartburn and sour regurgitation after surgery. It could be recommended widely in clinics.
出处
《中国现代医学杂志》
CAS
北大核心
2015年第27期81-84,共4页
China Journal of Modern Medicine
