目的 探讨食管癌不同术式术后食管反流发生情况,以寻求最佳术式.方法 选取行消化道重建的食管癌患者168例,根据吻合口位置,分为胸内吻合组、食管床吻合组及颈部吻合组各56例；术后连续24h监测食管腔内PH值,三组间进行对比分析.结果 24h总反流次数、大于5min的反流次数、最长反流时间、PH值＜4的总时间及De-Meester总评分结果均为胸内吻合组＞食管床吻合组＞颈部吻合组.结论 食管癌手术不同程度的存在食管反流现象,但重建时较高吻合口位置可减少术后反流,缓解症状、提高生活质量.%Objective To approach esophageal reflux of patients after operation on esophageal cancer and seek the best style of operation. Methods 168 patients with ophageal cancer received operation on reconstructing digestive tract were divided into three group including intrachest inosculation, esophagus bed inosculation and cervical part inosculation. The pH of esophageal lumen, interclass contrastive were observed. Results 24h total times of refflux, >5min times of reflux, longest time of reflux, the total time of pH<4, and DeMeester Score of intrachest inosculation were larger than that of esophagus bed inosculation and cervical part inosculation, and that of esophagus bed inosculation were larger than that of cervical part inosculation. Conclusion The patients have esophageal reflux after operation on esophageal cancer, but the higher anastomotic stoma can reduce esophageal reflux, relieve symptom and improve quality of life.
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