改良胃食管吻合在食管癌切除术中的应用刘朝伦.DOCVIP

临床医学论文-改良胃食管吻合在食管癌切除术中的应用刘朝伦 【摘要】? 目的 探讨改良胃食管吻合术应用于食管癌切除术中预防吻合口狭窄的临床效果。方法 将接受食管癌切除术98例病人分为两组，实验组49例施行改良胃食管吻合，对照组采用传统的方法，胃食管单纯吻合法，比较两组病人术后吻合口狭窄发生率。结果 实验组49例病人术后随访3～30个月，通过食道吞钡或胃镜检查，提示无吻合口狭窄。对照组49例术后随访3～30个月，通过胃镜或食道吞钡摄片证实12例有不同程度的吻合口狭窄，其中吻合口宽度在0.5~0.7 cm之间8例，吻合口宽度在0.3~0.5 cm之间3例，吻合口宽度＜0.3 cm有1例，吻合口狭窄发生率达24%。两组比较差异均有显著性（P＜0.05）,实验组发生吻合口狭窄明显低于对照组。结论 改良胃食管吻合术有降低食管癌切除术后吻合口狭窄发生率的优点，有效减轻病员术后的痛苦，提高生存质量，值得临床上推广应用。 【关键词】? 改良胃食管吻合术；食管癌；食管癌切除术 ?? 　　Application of modified gastroesophageal anastomosis in esophageal carcinectomy??? 　　Abstract: Objective? To study the clinical effects of modified gastroesophageal anastomosis in esophageal carcinectomy to prevent stoma stenosis. Methods? Ninety eight cases of esophageal carcinectomy were divided into two groups. The research group with 49 cases, the modified gastroesophageal anastomosis was performed. The original method of gastroesophageal anastomosis was performed in the control group. The incidence of stoma stenosis was compared between the two groups. Results? Forty nine cases in the research group developed no stoma stenosis in the 3～30 months follow up by gastroscope or barium meal; while 12 cases of the control group developed stoma stenosis with different degree, of which 8 cases were with stoma diameter between 0.5～0.7 cm, 3 cases between 0.3～0.5 cm, 1 case less than 0.3 cm. The incidence of stoma stenosis reached 24% in control group. The difference was significant between the two groups (P＜0.05). The incidence of stoma stenosis was significantly lower than that of control group.Conclusion? Modified gastroesophageal anastomosis in esophageal carcinectomy could prevent stoma stenosis, relieve the pain and elevate the living quality. So its clinical application would be valuable.??? 　　Keywords: modified; gastroesophageal anastomosis; esophageal carcinoma; esophageal carcinectomy??? 　　食管癌术后吻合口狭窄在临床中较常出现，病人会有不同程度的吞咽困难，从而影响正常生活，影响建康的恢复，我院从2003年3月至2006年11月，采用改良胃食管吻合术，用以防止食管癌术后吻合口狭窄，获得明显疗效，现报道如下。 　　1? 资料与方法 　　1.1? 临床资料? 本