刘俊峰、田子强、王其彰：050011 石家庄，河北医科大学第四医院胸外科，赵新明、王建方、魏兰秀、徐芳：ECT室 中华核医学杂志 1999 0 19 3


    关键词：胃肿瘤；贲门；胃切除术；胃排空 期刊 zhhyxzz 0 消化系统功能测定和显像 fur -->


    

摘要 目的 观察贲门癌术后残胃排空功能变化，探讨改善病人术后生活质量的方法。方法 用豆奶粉40g,水200 mL,加入18.5 MBq ⁹⁹ Tc^m -DTPA,制成试验餐,于术后18～20d对25例行贲门癌近端胃次全切除患者[附加幽门括约肌捏断17例(A组),单纯近端胃次全切除8例(B组)]和5例健康人(N组)进行核素胃排空检查。结果 口服试验餐后105min之内,每一时刻的胃排空率B组均低于A组(P均<0.01)和N组(P均<0.05),而A组与N组差异无显著性(P均>0.05)。B组的半量胃排空时间为(61.5±7.0)min,较A组(25.6±5.6) min(P=0.0013)和N组(33.6±6.1) min(P=0.026)明显延长,而A组的半量胃排空时间与N组差异无显著性(P>0.05)。结论 贲门癌行近端胃次全切除术后，残胃排空延缓，若附加幽门括约肌捏断术，则明显加快残胃排空,改善术后症状。

Gastric emptying after proximalsubtotal gastrectomy for cardiac cancer

LIU Junfeng,ZHAO Xinming,TIAN Ziqiang,etal.Fourth Hospital,Hebei Medical University,Shijiazhuang 050011

Abstract Objective To assessemptying of the remaining stomach after proximal subtotal gastrectomy for cardiaccancer,and to explore a method improving the life quality of postoperative patients.Methods Radionuclidegastric emptying test was performed on 17 patients who underwent proximal subtotalgastrectomy plus disruption of pyloric sphincter (PSG+DPS) by manipulative nipping and on8 patients who underwent proximal subtotal gastrectomy (PSG) only 18 to 20 d before,and on5 normal controls.Test meal was prepared from the mixture of soybean milk powder (40g),water (200 mL) and ⁹⁹ Tc^m -DTPA (18.5 MBq) as a tracer.Results Duringthe first 105 min after ingestion of test meal,gastric emptying rate at each time waslower in PSG group than those in PSG+DPS group (P<0.01) and normal controls(P<0.05).However,the gastric emptying rate did not show significant difference betweenPSG+DPS group and normal controls (P>0.05).The time required for the stomach to emptyhalf of its radioactive content (T_1/2 ) was longer in the patients who had PSGonly [(61.5±7.0) min ] than that in those who underwent PSG+DPS [(25.6±5.6) min],(P=0.0013)and normal controls [(33.6±6.1) min],(P=0.026).However,there was no significantdifference regarding T_1/2 between the patients with PSG+DPS and normal controls(P>0.05).Conclusions Proximal subtotal gastrectomy inevitably delaysthe emptying of remaining stomach,and DPS can effectively accelerate its emptying andimprove postoperative symptoms.

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