【作者】 刘俊峰； 于军辉； 刘磊； 张少为； 田子强； 张月峰； 李勇； 曹富民； 李保庆； 王福顺； 王其彰；

【Author】 Liu Jun - Feng Yu Jun - Hui Liu Lei et al. The Department of Thoracic Surgery, The Fourth Hospital of Hebei medical university & Hebei provincial tumor hospital ,Shijiazhuang,050011,China

【机构】 河北医科大学第四医院河北省肿瘤医院胸外科；

【摘要】 目的:探讨食管癌手术后血液中胃动素和胃泌素水平的变化及其对胸腔胃电活动及其对胸腔胃电活动和排空的影响。方法:食管癌手术采用常规左侧后外侧切口,切除食管癌后采用手工方法进行食管胃吻合。对52例受试者进行了胃电图检查和血液胃动素以及胃泌素检查,并对32例受试者进行了显示子的胃排空检查。结果:食管癌术后胸胃排空较术前和正常对照组明显延缓,并随时间推移有所恢复,但到术后2年,胸胃排空仍不能达到正常水平。术后第六天,胃电图波幅和频率明显低于术前,手术第十二天之后,上述指标逐渐恢复,但到术后180天时,各指标与术前组比较差异仍有统计学意义;术后360天时,波幅和频率均恢复到术前对照组水平,差异无统计学意义。食管癌术前血浆胃动素和血清胃泌素均高于正常对照组,至术后1年,仍持续高于正常对照组。术后空腹血清胃动素水平与胃电图波幅和频率呈显著正相关(P 值分别为0．000和0．006)。术后血浆胃泌素水平与胃电图波幅和频率呈显著正相关(P值分别为0．000和0．047)。术后空腹血清胃动素和血浆胃泌素水平均与120分钟胃排空率呈正相关(P值分别为0．001和0．000)。结论:食管癌术后血液胃动素和胃泌素水平持续增高具有重要的生理意义,可以促进胃电活动、胃蠕动、胃排空的逐渐恢复。更多还原

【Abstract】 Objective:The study was carried out to look at the effects of blood motilin and gastrin on the electrical activity and emptying of the intrathoracic stomach after esophagectomy for cancer. Methods:Oesophagectomy and gastroesophagostomy were performed through posterolateral thoracic incision, using hand - sewn anastomosis. Electrogastrography and tests for blood motilin and gastrin were carried out in 52 patients,and gastric emptying was examined in 32 of them.Results: Gastric emptying became slow compared with normal controls and then gradually improved overtime, but could not reach normal until 2 years after surgery.The amplitude and frequency of electrogastrogram (EGG) showed the same trend as gastric emptying but it reached normal at 1 year after surgery. When compared with normal controls, the level of blood motilin and gastrin was significantly elevated in pre - and post - operative patients and the high level maintained for at least one year. Postoperative blood motilin and gastrin level positively correlated with altitude, frequency of the EGG and intrathoracic gastric emptying. Conclusion: Persistent elevation of blood gastrin and motilin in patients who underwent esophagectomy for cancer is physiologically important,and facilitates the recovery of electrical activity and emptying of the intrathoracic stomach.更多还原