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目的:减轻食管癌术后胃-食管反流,提高患者生存质量。方法:561例食管中下段癌患者随机分为治疗组(281例)及对照组(280例),手术均采用改良Ivor-Lewis术式,术后对照组采用补液、全静脉营养及吗丁啉、奥美拉唑等常规治疗,治疗组在常规治疗基础上采用以红霉素为主的综合治疗,术后观察1个月,比较2组症状性反流、病理性反流及隐匿性反流发生率。结果:术后1个月治疗组症状性反流、病理性反流、隐匿性反流发生率分别为10.68%,22.78%,9.96%,明显低于对照组的87.86%,10.00%,45.00%,2组比较差异有统计学意义(P<0.05)。结论:以改良Ivor-Lewis术式为基础、联合术后红霉素应用为主的综合治疗,能有效预防和治疗食管癌术后胃-食管反流。
Objective: To reduce gastroesophageal reflux after esophageal cancer and improve the quality of life of patients. Methods: A total of 561 patients with cancer of the lower esophagus were randomly divided into a treatment group (281 cases) and a control group (280 cases). The operation was performed with modified Ivor-Lewis operation. The postoperative control group was treated with fluid replacement, total intravenous nutrition and domperidone. Routine treatment such as omeprazole was used in the treatment group on the basis of routine treatment with erythromycin-based comprehensive treatment. One month after surgery, the two groups were compared for symptomatic reflux, pathological reflux, and occult antigenicity. Flow rate. Results: The incidence of symptomatic reflux, pathological reflux, and occult regurgitation in the treatment group was 10.68%, 22.78%, and 9.96%, respectively, which was significantly lower than the control group’s 87.86%, 10.00%, 45.00%. There was a statistically significant difference between the two groups (P<0.05). Conclusion: The comprehensive treatment based on the modified Ivor-Lewis operation combined with postoperative erythromycin can effectively prevent and treat gastro-oesophageal reflux after esophageal cancer surgery.