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目的:探讨近端胃切除+幽门成型术的抗反流作用。方法:近端胃切除术同时以幽门为中点纵形切开约2.5 cm,并横行缝合,以扩大幽门开放程度,促进胃排空。结果:106例患者手术后幽门平均宽度1 cm,平均胃排空时间43 min,与随机抽取的60例未行幽门成型术的病例(对照组)进行比较,胃排空时间明显加快,差异有统计学意义(P<0.05),吞咽哽噎症状明显减轻。结论:幽门成型术对防治近端胃切除术后食物反流症状和反流性食管炎疗效确切,但对胃切除>70%者不可勉强实施幽门成型。
Objective: To investigate the anti-reflux effect of proximal gastrectomy and pyloroplasty. Methods: proximal gastrectomy at the same time to pylorus longitudinal incision about 2.5 cm, and transverse suture to expand pyloric degree of opening and promote gastric emptying. Results: The average pyloric width at 1 cm and the average gastric emptying time of 106 patients after operation were 60 and 60 days, respectively. Compared with the 60 cases without pyloric surgery (control group), the gastric emptying time obviously accelerated, with the difference being Statistical significance (P <0.05), swallowing symptoms significantly reduced. Conclusion: Pyloroplasty is effective in preventing food reflux symptoms and reflux esophagitis after proximal gastrectomy. However, pyloroplasty can not be implemented with more than 70% of patients undergone gastrectomy.