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目的 研究保留迷走神经干的可行性、指征及其引起的消化功能改变状况。方法 通过保留或切断迷走神经干 ,对食管癌手术患者的消化功能进行术前、术后自身对照研究。结果 (1)按Angom计分评估 ,保留组较切断组临床症状有所改善 ;(2 )术后两组患者胸胃排空较术前均有延迟 ,但切断组更为明显 (P <0 .0 1) ;(3)基础胃酸分泌量及 2 4hpH监测发现 ,保留组患者术前、术后无明显差别 ,而切断组术后较术前明显降低 ;(4)空腹血清胃泌素切断组术后较术前明显升高 ,而保留组升高无显著意义 ;(5 )纤维内窥镜检查显示 ,切断组与保留组患者术后萎缩性胃炎的发生均较术前有一定程度增加。结论 保留迷走神经干的食管癌切除术有利于提高患者术后的胃消化功能及生活质量。
Objective To study the feasibility, indications, and changes in digestive function of vagal nerve preservation. Methods By preserving or cutting off the vagus nerve, the digestive function of esophageal cancer patients undergoing preoperative and postoperative self-control studies. Results (1) According to the Anom score, the clinical symptoms of the reserved group were better than that of the cut group; (2) Postoperative thoracic gastric emptying was delayed in both groups compared with preoperative, but it was more pronounced in the cut group (P < 0). .0 1) (3) Basal acid secretion and 24-hour pH monitoring revealed no significant difference between the preoperative and postoperative groups in the retentive group, but it was significantly lower in the severed group than in the preoperative group; (4) Severe fasting of serum gastrin The postoperative group was significantly higher than before surgery, but there was no significant increase in the retained group. (5) Fiber endoscopy showed that the incidence of postoperative atrophic gastritis in both the severed group and the retained group was increased compared with preoperative. . Conclusions Esophageal cancer resection with vagal nerve stems is beneficial to improve postoperative gastric digestive function and quality of life.