目的 :探讨膈肌剧烈运动对弓下胃食管吻合口的影响和对策。方法 :X线透视荧光屏观察记录术前膈顶 ,术后膈顶、膈胃裂孔及吻合口 ,随呼吸方式不同的运动幅度变化。结果 :术前膈顶运动幅度变化见表 1,术后膈顶、膈胃裂孔及吻合口运动幅度变化见表 2。结论 :膈肌剧烈运动对弓下胃食管吻合口张力影响大 ,影响吻合口愈合 ,甚至导致吻合口瘘的发生。加强围手术期处理 ,减少膈肌剧烈运动的诱发因素 ,术中无张力或减张力吻合 ,可减少吻合口瘘的发生 Objective: To investigate the effect of diaphragmatic muscle strenuous exercise on the inferior esophageal anastomotic arch and its countermeasures. Methods: X - ray fluoroscopy screen before surgery to record the top of the diaphragm, postoperative diaphragm top, diaphragm and stomach anastomosis, with different breathing patterns of exercise changes. Results: Preoperative changes in the amplitude of the diaphragm top movement in Table 1, after the top of the diaphragm, diaphragm gastric orifice and anastomosis changes in amplitude shown in Table 2. CONCLUSION: Severe diaphragmatic exercise has a great effect on the tension of esophageal anastomotic staples under the bow, which affects the anastomotic healing and even leads to the occurrence of anastomotic fistula. Strengthen the perioperative management, reduce the vigorous exercise of the diaphragm caused by factors that no tension or reduction during surgery, can reduce the occurrence of anastomotic leakage