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目的研究全胃切除食道空肠吻合病人的小肠运动生理与排空功能。方法应用小肠多点持续式灌注测压研究10例全胃切除病人的 Roux 肠袢运动;核素显像测量小肠排空时间,并与12例 B-Ⅱ式远端胃大部切除病人和7例正常人相比较。结果正常对照、胃大部及全胃切除组的口一结肠传递时间(MCTT)分别:197.00±7.59、202.58±8.66及其237.22±9.46(min),差异显著(F=5.52,P<0.05),提示全胃切除 Roux-Y 食道空肠吻合可能延缓小肠食物传递;空肠 Roux肠袢试餐半排空时间:8.3±3.43(min)。Roux 肠袢运动均有不同程度异常,表现消化间期 MMC 活动缺乏,逆向传播等;消化期运动削弱,个别异常小肠收缩波引起餐后腹痛。结论全胃切除 Raux-Y 食道空肠吻合可诱发 Roux 肠绊运动紊乱,但无碍食物通过该肠绊,而严重者与餐后不适相关。
Objective To study the small intestine exercise physiology and emptying function of total gastrectomy esophagojejunostomy. Methods Routine multi-point perfusion intestine was used to study Roux bowel movement in 10 patients who underwent total gastrectomy; nuclide imaging was used to measure the time of intestinal emptying and was compared with 12 patients with B-II distal gastrectomy and 7 Comparison of normal people. Results Mouth-to-colon transit time (MCTT) was 197.00±7.59, 202.58±8.66 and 237.22±9.46 (min) in the normal control, gastric and total gastrectomy groups, respectively (F=5.52, P<0.05). , suggesting that total gastrectomy Roux-Y esophagus jejunal anastomosis may delay the small intestine food delivery; jejunum Roux bowel meal half emptying time: 8.3 ± 3.43 (min). Roux bowel movements were abnormal in various degrees, showing that there was a lack of MMC activity during the interdigestive period, and adverse transmission, etc.; digestive exercise was weakened, and individual abnormal small bowel contractions caused postprandial abdominal pain. Conclusion Total gastrectomy Raux-Y esophageal jejunostomy can induce Roux bowel movement disorder, but does not prevent food from passing through the fistula, and severely related to postprandial discomfort.