十二指肠球部霜斑状溃疡63例内镜分析

十二指肠球部霜斑溃疡是一种特殊类型的消化性溃疡，在内镜检查时可见充血黏膜区有多个散在小白苔，形如霜斑，儿无明显的黏膜凹陷缺损。我院1996年1月至2005年1月，经内镜检出63例，现报告如下。     

内镜下综合治疗十二指肠球部溃疡出血65例疗效分析

目的探讨经内镜下综合治疗十二指肠球部溃疡出血的临床价值。方法对2005年1月至2008年7月共65例经内镜综合治疗的十二指肠球部溃疡出血患者的临床资料进行回顾性分析。结果65例患者止血成功57例，初次治疗成功率为87．6％。再出血8例，再次内镜下止血4例成功，4例治疗无效转外科手术治疗，总有效率为95．3％。结论内镜下综合治疗十二指肠球部溃疡出血是一种安全、有效的方法，应该作为首选方法在临床上推广应用。     

国产奥美拉唑治疗十二指肠球部溃疡

为探讨国产奥美拉唑（Omeprazole）治疗十二指肠球部溃疡（DU）的疗效，笔者收集1993～1995年120例DU患者的临床资料进行分析，分三组，一组用国产奥美拉唑（由锦州制药厂提供）治疗，并与另二组进口奥美拉唑和法莫替丁进行比较，结果报告如下。1资料与方法1．1病例选择：120例均有上消化道症状，由胃镜确诊为活动期DU，随机分成三组，每组40例。其中男93例，女27例，平均年龄38士19岁（17～72岁），均符合下列标准：（1）溃疡直径＞smm或＜1．smm，数目＜2个；（2）无复合性溃疡，幽门梗阻和活动性出血；（3）近期无使用可诱发溃疡的药…     

十二指肠球部溃疡并存胃癌临床分析

目的了解十二指肠球部溃疡并存胃癌的发病情况及临床特点。方法无选择地收集国内文献近年来公开报道的十二指肠球部溃疡并存胃癌163例,加上本院5例共168例,所有病例均经内镜或（和）手术病理证实。结果十二指肠球部溃疡并存胃癌占同期镜检人数的0.11%（102/92982）,占十二指肠球部溃疡的0.65%（139/21243）,占胃癌的2.9%（86/2951）,占复合性溃疡的3.0%（23/779）,男女之比为3.0∶1,中位年龄49-63岁,平均56.4岁,病程2个月-40年不等,常见症状有腹痛、呕血及黑便、纳差、消瘦等。病灶近一半位于胃窦及角切部,Borrmann分型以Ⅱ型及Ⅲ型为主（占79.3%）,病理以管状腺癌多见（占61.7%）,其次为低分化腺癌（占19.2%）及印戒细胞癌（10.0%）。结论十二指肠球部溃疡并存胃癌临床无特异性症状,故胃镜检查发现十二指肠球部溃疡后,切不可忽视对胃部的全面观察,并应常规活检,发现胃部癌肿后,仍应尽可能进入十二指肠,以发现是否有共存病变,为选择手术方式及进一步治疗提供依据。     

胃十二指肠球部溃疡穿孔91例临床分析

胃十二指肠溃疡穿孔是外科常见的急腹症之一，往往需要外科紧急处理，但处理的方法又不尽相同。我院于1994～2004年间共收治91例该类患者。现报告如下：     

无痛性十二指肠球部溃疡出血34例

无痛性十二指肠球部溃疡临床容易误诊。正确认识和处理并发的出血征对预后有较大的相关性。为更好地诊治该类疾病，现将我院有关临床资料总结分析如下。     

难治性十二指肠球部溃疡伴发肿瘤6例分析

目的探讨难治性十二指肠球部溃疡的病因,提高对十二指肠球部溃疡与肿瘤并存临床特点的认识,减少误诊率及漏诊率。方法收集临床资料完整并行病理活检的6例十二指肠球部溃疡伴发肿瘤患者的临床资料,分别从临床表现、实验室检查、影像学、病理学、治疗与转归等方面归纳总结,并结合文献进行分析。结果 6例患者术后均证实为十二指肠球部溃疡伴发肿瘤,其中5例合并有不同程度幽门梗阻。并有病程治疗时间长、病情反复、体质量下降、营养不良等表现,内镜检查为十二指肠球部溃疡,病理活检诊断多为慢性炎症、溃疡,需要反复多次病理活检,甚至行外科手术病理检查方可确诊。临床误诊、漏诊率较高。结论难治性十二指肠球部溃疡应警惕合并肿瘤的可能,内镜检查是目前明确诊断的主要手段,但误诊、漏诊率较高。提高对本病的认识,重视反复多次病理活检是降低误诊、漏诊率的关键。     

十二指肠球部隆起性病变的内镜及病理分析

目的：探讨十二指肠球部粘膜隆起性病变的内镜表现及病理改变。方法：通过胃镜或超声胃镜观察了324例十二指肠球部隆起性病变，经活捡或电切后行病理检查。结果：内镜表现为单个或多个广基息肉状隆起，其中以单个无蒂隆起为多，绝大多数在1.0cm以内，大于1．0cm共5例。病理检查十二指肠球部粘膜病变有Brunner腺增生、胃上皮化生、炎性隆起、良性淋巴组织增殖、肠腺上皮异型增生、腺瘤性息内、囊肿。平滑肌瘤及异位胰腺各1例。结论：本组十二指肠息肉样隆起性病变均为良性病变。     

Gastric emptying in patients with gastric and duodenal ulcer

Gastric emptying was measured in patients with proximal gastric, distal gastric and duodenal ulcers using a radioisotopic method. Gastric emptying was rapid in patients with proximal gastric ulcer, and was considered to be due to accelerated proximal evacuation. However, emptying was delayed in patients with distal gastric ulcer, and was considered to be due to reduced emptying in the antrum. On the other hand, rapid emptying seen in duodenal ulcer patients was considered to be due to accelerated emptying in both the proximal stomach and the antrum. Gastric emptying in the healing stage was closer to that in healthy subjects than in patients with active-stage ulcer.     

胃十二指肠溃疡穿孔腹腔镜修补术后随访分析

目的总结腹腔镜胃十二指肠溃疡穿孔修补术的治疗效果。方法应用腹腔镜对27例胃十二指肠溃疡急性穿孔的病人行穿孔修补术,分别于术后2、6、12月进行胃镜随访,观察溃疡修复、演变过程。结果27例腹腔镜下穿孔修补术均成功,无中转开腹和手术并发症及死亡。术后平均（8．41±1．16）d出院。术后行胃镜随访26例溃疡完全愈合,1例因幽门梗阻行胃大部切除术。结论腹腔镜胃十二指肠溃疡穿孔修补术,创伤小,恢复快,术后并发症少。     

心理干预护理对消化性溃疡的效果分析

目的 探讨胃、十二指肠溃疡患者采用心理干预护理的效果.方法 将我院2008年1月至2009年7月收治的71例胃、十二指肠溃疡患者按入院次序分为对照组和实验组,比较分析两组的护理效果.结果 实验组患者的护理效果优于对照组,且恢复所需时间短,复发率低.结论 胃、十二指肠溃疡患者采用心理干预护理有利于患者的早日康复,值得在临床护理工作中推广应用.     

Treatment of gastric and duodenal ulcers during endoscopy

The author reviews the results of the local treatment of 142 patients for peptic ulcer of the stomach (24 patients) and duodenum (67 patients). In 51 cases, symptomatic ulcers were diagnosed. Use was made of a complex of surgical and therapeutic endoscopic interventions. The local treatment of gastroduodenal ulcers made it possible to attain positive results with a complete ulcer cicatrization and disappearance of the clinical symptom-complex in 105 (83.3%) out of the 142 patients. The effect was transient in 24 (16.3%) patients. The ulcer did not heal in 13 (9.1%) patients. The follow up studies for 2 to 5 years revealed no relapses in 79.5% of patients. No complications were recorded. Indications and contraindications as to the therapeutic endoscopy were determined with regard to the clinical and esophagogastroduodenoscopy data and histological examination of biopsy material.     

Effects of parenteral secretin--cholecystokinin and of duodenal acid perfusion on gastric secretion in duodenal ulcer patients.

The effect of parenteral secretin-cholecystokinin and duodenal acid perfusion on broth-stimulated gastric acid secretion was studied in 11 duodenal ulcer patients. Statistically significant inhibition occurred in both experimental conditions. The effect of secretin-cholecystokinin was more marked than the effect of duodenal acid perfusion. A poorly responsive subgroup of patients appeared to be responsible for the diminished inhibitory effect of duodenal acid perfusion. In this poorly responsive group there was a diminished duodenal volume response as well as diminished duodenal acid clearing. We conclude that there may exist a diminished release of gastrointestinal hormones such as secretin and cholecystokinin in certain duodenal ulcer patients.