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目的寻找一种实用有效的抗反流食管胃吻合术式。方法将食管癌和贲门癌患者464例随机分为黏膜瓣式食管胃吻合术组(A组,175例)、器械食管胃吻合术组(B组,151例)和单纯手工缝合食管胃一层吻合术组(C组,138例)。应用同位素测定胃食管反流指数和24h监测pH值,进行3组间的食管运动功能比较。结果同位素测定胃食管反流指数显示,A组反流阳性率为0,B组为33.3%,C组为6.7%。食管运动功能及24h监测pH显示,A组检测各项指标均接近正常值,B、C组与正常值比较,差异具有统计学意义(P<0.05)。结论黏膜瓣式食管胃吻合术式具有优异的抗反流功能,并能有效地防止食管癌、贲门癌术后反流性食管炎的发生。
Objective To find a practical and effective anti-reflux esophageal anastomosis type. Methods 464 patients with esophageal and cardiac cancer were randomly divided into mucosal flap esophagogastric anastomosis (group A, 175 cases), apparatus esophagogastric anastomosis (group B, 151 cases) and manual esophagogastric layer Anastomosis group (C group, 138 cases). Gastroesophageal reflux index was measured using isotope and 24h pH value was monitored to compare the esophageal motility function among the three groups. Results The isotope determination of gastroesophageal reflux index showed that the positive rate of reflux was 0 in group A, 33.3% in group B and 6.7% in group C, respectively. Esophageal motility function and 24h monitoring of pH showed that all indexes in group A were close to normal, and there was significant difference between group B and group C (P <0.05). Conclusion Mucosal flap esophagogastrostomy has excellent anti-reflux function and can effectively prevent the occurrence of reflux esophagitis after esophageal cancer and cardiac cancer.