食管贲门癌切除胃底重建术中保留迷走神经临床应用价值分析.docVIP

食管贲门癌切除胃底重建术中保留迷走神经临床应用价值分析 　　【摘要】 目的：探讨食管贲门癌切除胃底重建术中保留迷走神经的临床价值。方法：选择笔者所在医院39例行食管贲门癌根治性切除术患者，手术采用胃底重建术，并保留迷走神经作为观察组，另选取同期收治的39例常规手术患者作为对照组，术后对患者进行随访，对患者的临床疗效、并发症、胃镜检查结果及消化功能进行评价。结果：所有患者术后临床症状均得到了有效缓解，两组患者术后并发症发生率比较差异无统计学意义（P0.05）。术后随访1年，患者均生存，观察组患者反流性食管炎发生率为17.9%，低于对照组患者的33.3%，差异有统计学意义（P0.05）。观察组患者的食管体部静息压和收缩压均优于对照组（P0.05）。结论：食管贲门癌切除胃底重建术中保留迷走神经能够改善患者的消化功能，延长生存时间，提高生活质量。 　　【关键词】 食管癌； 贲门癌； 胃底重建； 迷走神经； 消化功能 　　中图分类号 R735.1 文献标识码 B 文章编号 1674-6805（2015）6-0015-02 　　【Abstract】 Objective：To study the value of reconstruction of gastric fundus with vagus nerve preserved in resection of esophageal and cardia cancer.Method：39 cases of esophageal and cardia cancer in our hospital who treated by gastric fundus with vagus nerve preserved operation were selected as the observation group，and 39 cases of who were treated by routine operation were selected as the control group，the clinical effect，complications，gastroscopy results and digestive function were analysed.Result：After operation clinical symptoms of all cases were alleviated effectively，the difference of complications between two groups were no statistically significant（P0.05）.After 1 year following up，all cases were survival，the reflux esophagitis incidence rate of the observation group was 17.9%，it was lower than that in the control group（33.3%），there was significant difference between two groups（P0.05）.The esophageal body resting pressure and systolic pressure of the observation group were superior than that in the control group（P0.05）.Conclusion：Reconstruction of gastric fundus with vagus nerve preserved in resection of esophageal and cardia cancer has good effect，can prolong the survival time and improve the quality of life. 　　【Key words】 Esophageal cancer； Cardia cancer； Reconstruction of gastric fundus； Vagus nerve； Digestive function 　　First-author’s address：Xiaochang County Maternal and Child Health Hospital，Xiaochang 432900，China 　　doi：10.14033/j.cnki.cfmr.2015.06.007 　　食管贲门癌是临床较为常见的一种消化道恶性肿瘤，胃底重建术是食管贲门癌切