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61.
Polito C La Manna A Mansi L Rambaldi PF Papale MR Marte A Di Toro R 《Pediatric nephrology (Berlin, Germany)》1999,13(9):876-879
Body growth was studied in 32 subjects with vesicoureteric reflux (VUR), diagnosed following the prenatal finding of urinary
tract dilatation, who had normal renal filtration function and who received antibacterial prophylaxis by the first few days
of life. They were followed for 1–5 years (mean 2.3 years). Most had persistent VUR during the 1st year of life. Body growth
performance was compared with that of 94 subjects with VUR diagnosed and treated by us after the neonatal period. During the
follow-up period, none of the patients with prenatally detected VUR had a height Z score below –2, nor a weight-for-height
index below 90%, and 1 had variations in height Z score ≥1. The difference in the percentage of patients with prenatally detected
VUR (1/32) and those with VUR diagnosed and treated after the neonatal period (20/94) who had variations in height Z score
≥1 was significant (P=0.035). Patients with prenatally detected VUR and normal renal filtration function, given antibacterial prophylaxis by the
first few days of life, have normal body growth, although VUR still persists.
Received: 19 March 1998 / Revised: 10 February 1999 / Accepted: 10 February 1999 相似文献
62.
Evaluation of esophageal bile reflux after total gastrectomy by gastrointestinal and hepatobiliary dual scintigraphy 总被引:2,自引:0,他引:2
Conducting the qualitative evaluation of reconstruction methods is difficult because of their complexity. The aim of the present
study was to compare esophageal bile and food reflux by performing gastrointestinal and hepatobiliary dual scintigraphy (GHDS)
after various methods of reconstruction following total gastrectomy. Of 17 patients studied, 4 had undergone Roux-en-Y anastomoses
(R-Y); 6, jejunal pouch-Y anastomoses (P-Y); and 7, jejunal pouch interposition (P-I). GHDS was performed 1 year after surgery
using111In-diethylene triamine pentaacetic acid administered orally, and99mTc-pyridoxyl-5-methyl tryptophan administered intravenously. Imaging data from a gamma camera were stored in and processed
by a data analyzer. Three patients who had undergone R-Y and one who had undergone P-I complained of heartburn, while one
who had undergone R-Y, two who had undergone P-Y, and three who had undergone P-I complained of a feeling of fullness. Esophageal
bile reflux was confirmed by GHDS in four of the patients who had undergone R-Y, one who had undergone P-Y, and four who had
undergone P-I. Moreover, GHDS demonstrated food retention in two patients who had undergone R-Y, five who had undergone P-Y,
and four who had undergone P-I. Weight loss was closely related to the esophageal reflux of bile or food which can be accurately
detected by GHDS. Despite the absence of heartburn, patients diagnosed as having bile reflux by GHDS showed poor recovery
of body weight. 相似文献
63.
Roux-Y Gastric Bypass: an effective anti-reflux procedure 总被引:1,自引:0,他引:1
Gastric limiting procedures have made an improvement in the lives of those patients in whom they have been successful. Not
only have there been marked improvements in diabetes, hypertension, and arthritis, but there have been a number of other ‘spin-offs’,
not the least of which is control of reflux esophagitis by totally eliminating the secretion of the parietal cell mass of
the stomach from rising into the esophagus. We compared a group of 100 obese patients with reflux esophagitis who underwent
Roux-Y gastric bypass (RYGBP) to a normalsized group of 23 patients on whom we had done Nissen fundoplications in the past.
Visick gradings I-II of 100% vs 87%, respectively, may indicate a superiority of RYGBP over the Nissen procedure. Although
the groups and time periods are too divergent to draw statistically significant conclusions, one can see that the RYGBP population
was apparently better served considering their cure of ‘heartburn’ and other reflux symptoms as well as their achievement
of sustained weight loss. 相似文献
64.
目的 通过动物实验 ,研究十二指肠液反流对食管上皮的损伤及评价铝碳酸镁对食管粘黏损伤的预防和治疗作用。方法 16 0只SD大鼠 ,♂ ,2 0只为正常空白对照 (C组 ) ,14 0只行全胃切除 +食管空肠吻合术 ,术后 2周存活的大鼠随机分为A、B两组 ,A组予以铝碳酸镁管喂 ,B组管喂等量的生理盐水 ,术后 10周处死所有的大鼠 ,对食管上皮进行大体形态、病理学及电镜观察。结果 A、B两组的食管有程度不同的反流性食管炎 ,组织学表现为炎症、糜烂、溃疡、鳞状上皮增生、Barrett上皮化生及不典型增生。B组的炎症程度重于A组 (P <0 .0 1) ,Barrett上皮化生及不典型增生的发生率明显高于A组 (P <0 .0 5 )。B组有 1例食管微灶腺癌形成。扫描及透射电镜发现B组有Barrett化生的食管上皮典型分泌型肠上皮的特征。结论 铝碳酸镁能有效保护十二指肠液反流的食管粘黏 ,预防及治疗因其所致的多种病理学损害 相似文献
65.
陈赞雄 《中国临床药理学与治疗学》2003,8(2):204-206
目的:观察胃力康治疗反流性食管炎的临床疗效和安全性。方法:80例反流性食管炎患随机分为胃力康组40例,用胃力康颗粒10g,po,tid;多潘立酮多潘立酮组40例,用多潘立酮10mg,po,tid,疗程均为6wk。结果:胃力康在治疗6wk后打嗝、反酸,反食,胃部不适和吞咽后胸痛等症状改善,总有效率为85.0%,多潘立酮总有效率为60.0%(P<0.05)。结论:胃力康能明显缓解反流性食管炎患的临床症状,疗效优于多潘立酮,不良反应轻微,是治疗反流性食管炎有效,安全的药物。 相似文献
66.
胃食管反流病中医诊疗研究进展 总被引:1,自引:0,他引:1
综述了近年来中医对胃食管反流病的诊断与治疗概况,认为目前本病还没有一个统一、公认的中医辨证分型方法和标准,临床医生常根据自身的经验来辨证分型、选方用药。今后需加强中医诊治胃食管反流病的客观化与标准化研究,进一步提高诊疗水平。 相似文献
67.
胃逆康胶囊治疗反流性食管炎临床观察 总被引:2,自引:0,他引:2
目的 :客观评价胃逆康胶囊治疗反流性食管炎的临床疗效及安全性。方法 :选取经内镜检查符合反流性食管炎诊断标准的患者 185例 ,分 2个阶段观察 ,第一阶段为 1∶ 1随机双盲对照试验 ,胃逆康组 32例 ,吗丁啉组 33例 ;第二阶段为 3∶ 1的扩大随机对照试验 ,采用双模拟法 ,胃逆康组 90例 ,吗丁啉组 30例。治疗组予胃逆康胶囊 4粒 ,安慰剂片 1片 ;吗丁啉组予吗丁啉片 10 mg,安慰剂胶囊 4粒。均为饭前 30 m in口服 ,每日 3次 ,8周为 1疗程。结果 :胃逆康组近期痊愈 5 6例 ,显效 2 5例 ,有效 34例 ,无效 7例 ,总有效率为 94 .3% ;对照组近期痊愈 11例 ,显效 15例 ,有效 33例 ,无效 4例 ,总有效率为 93.7%。胃逆康组总疗效明显优于吗丁啉组 ( u=3.6 7,P=0 .0 0 0 2 3) ;对烧心、胸痛、反酸、打嗝等症状的消除率依次为 6 5 .4 %、72 .2 %、6 6 .7%和 78.0 % ,明显优于吗丁啉组的症状消除率 ,依次为 4 4 .1%、5 0 .0 %、4 9.1%和 4 7.4 % ( P<0 .0 5 ) ;胃逆康组内镜检查复常率为 5 2 .4 6 % ,优于吗丁啉组 33.33% (χ2 =6 .12 ,P=0 .0 13)。胃逆康组治疗前后血尿便常规、肝肾功能和心电图检查均无异常 ,有 3例出现轻度腹泻 ,2~ 5日自行消失。结论 :胃逆康胶囊治疗反流性食管炎功效明显优于吗丁啉 ,且使用安全 相似文献
68.
69.
贲门癌切除机械吻合术后的胃食管反流 总被引:3,自引:1,他引:3
目的:探讨贲门癌切除食管胃机械吻合术后重建食管与胃食管反流之间的关系.方法:对30例术后患者进行食管胃压力测定,其中16例行24h食管pH监测,12例行内镜检查和病理学检查.结果:测压结果显示:吻合口与吻合口下方的静息压相似,比较差异无显著性(P>0.05),而吻合口上方静息压增高,平均为3.42mmHg,经比较吻合口上方和吻合口下方差异有显著性(P<0.05).值得注意的是其压力值(3.42mmHg)远低于正常括约肌的静息压(10~45mmHg),因此其抗反流作用的程度是有限的.本组16例术后食管24h pH监测表明食管的酸暴露时间延长,食管酸暴露时间百分比平均为13.78%,为正常人的11倍,反流次数增加,最长反流时间达43min,说明手术后的胃食管反流是客观存在的.内镜检查和病理检查,83.3%有异常现象及食管炎征象,进一步证实术后患者有不同程度的反流性食管炎.结论:1)贲门癌切除食管胃吻合术后存在胃食管反流.2)反流的发生不因机械吻合或手工吻合而异.3)反流的发生与术后时间长短无关.4)24h食管pH监测是最敏感的观察方法.5)半卧位睡眠是预防反流的有效方法.6)反流的治疗主要应用促动力药和粘膜保护剂. 相似文献
70.
Background Duodenogastric reflux is known to cause an increased frequency of cancer in the glandular portion of the stomach in rats. Furthermore, it is debated whether inhibition of gastric acid secretion may promote gastric carcinogenesis. In the present study we examined the combined effect of gastroduodenal reflux and acid inhibition with respect to the development of gastric carcinoma in the rat.Methods Following the construction of a gastrojejunostomy in male Wistar rats, half of them were given the proton pump inhibitor lanzoprazole for 1 year. The rats were then killed and the pH in the stomach and gastrin in blood were measured. The stomach was examined macroscopically as well as histologically.Results Gastrin levels at autopsy were significantly increased in treated rats compared to the control group, confirming an effect of lanzoprazole on gastric acid secretion. Body weight was significantly reduced in the treated rats. Thirty of 79 rats developed gastric cancer, and they were all adenocarcinomas of the Lauren intestinal type. Gastric cancers occurred significantly more often in lanzoprazole-treated rats (50%) compared with controls (27%).Conclusion Lanzoprazole given orally enhances the carcinogenic effect of duodenogastric reflux in rats. 相似文献