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目的:分析食管贲门癌切除胃底重建术中保留迷走神经的价值。方法:采用随机数字表法将行食管、贲门癌切除主动脉弓下食管胃吻合术95例患者分为2组,对照组术中切断迷走神经并不行胃底重建术,观察组术中保留迷走神经加胃底重建手术,比较2组患者术后症状改善、上消化道压力和反流性食管炎情况。结果:观察组临床症状发生率明显低于对照组,P<0.01;观察组术后食管体部静息压高于正常组和对照组,P<0.05;对照组、观察组与正常组胃静息压比较,P>0.05;对照组反流性食管炎发生率53.19%明显高于观察组16.67%,P<0.01。结论:在早期无周围外侵的食管、贲门癌切除胃底重建术中保留迷走神经能够保持胃正常泌酸、运动和排空功能,在提高手术疗效和改善预后方面意义重大。
Objective: To analyze the value of preserving the vagus nerve during gastric resection of esophagus and cardia. Methods: A total of 95 cases of esophageal and gastric cardia resection aortic arch esophagogastrostomy were divided into two groups by random number table method. In the control group, vagotomy was not performed during operation and vagus nerve plus gastric fundus Reconstructive surgery was performed to compare the postoperative improvement of symptoms, upper gastrointestinal stress and reflux esophagitis in the two groups. Results: The incidence of clinical symptoms in the observation group was significantly lower than that in the control group (P <0.01). The resting pressure of the esophageal body in the observation group was significantly higher than that of the normal group and the control group (P <0.05). In the control group, Pressure-pressure comparison, P> 0.05; control group, the incidence of reflux esophagitis 53.19% was significantly higher than the observation group 16.67%, P <0.01. Conclusion: The preservation of the vagus nerve during gastric resection of esophagus and gastric cardia without peripheral invasion can maintain normal gastric acid secretion, exercise and emptying function, which is of great significance in improving surgical outcomes and prognosis.