保留幽门、胃窦浆肌瓣式胃大部切除术93例临床疗效分析

该文对施行保留幽门、胃窦浆肌(?)式胃大部切除术(简称PAFPG)后获得随访的93例(PAFPG 组)与同期施行毕罗胃大部切除术(毕罗组)获得随访的56例进行综合分析比较.结果表明:PAFPG 降酸肯定.按Visick 分级法评定疗效,PAFPG 组优良率为96.8%,毕罗组为80.4%.两组术后一年复查血清胃泌素均显著低于术前(P<0.01).胃镜检查提示PAFPG 肠胃返流率为14.3%,毕罗组为78.2%(B-Ⅰ式58.3%,B-Ⅱ式93.6%).胃粘膜活检显示毕罗组胃粘膜发生肠上皮化生、萎缩性胃炎和不典型增生的严重程度高于PAFPG 组.提示PAFPG 能有效减少肠胃返流.使胃内环境保持相对稳定.该研究可为术式选择及评价手术疗效提供一定的客观依据.     

MNNG诱发犬残胃粘膜癌前期病变组织中MG_7－Ag表达的动态定量研究

本实验在ＭＮＮＧ诱发犬胃粘膜癌前病变过程中，胃镜下定期粘膜活检。应用胃癌单克隆抗体ＭＧ７免疫组化染色法及自动化图像分析仪，连续动态定量地监测犬残胃癌前期病变组织中ＭＧ７抗原物质（ＭＧ７－Ａｇ）的表达情况。实验结果表明，①慢性萎缩性胃炎、肠化生及异型增生的组织细胞内已具有胃癌的某些生物学特性。②胃癌前期病变的演变过程可能遵循由萎缩性胃炎→肠化生→异型增生的变化规律。③临床上，重度异型增生患者有很高的癌变率，是由于重度异型增生组织内的某些生物学特性已非常接近于胃癌。     

Level of lipid peroxides and cuprozinc superoxide dismutase in gastric mucosa and serum of gastrectomized patients

The level of lipid peroxides (LPO) and copper-zinc containing superoxide dismutase (SOD-Ⅰ) in the gastric mucosa and serum was determined in 141 samples from 25 patients after con-ventional subtotal gastrectomy (11 cases of Billroth Ⅰ and 14 cases of Billroth Ⅱ) and 11 patientsafter pylorus and antroseromuscular flap preserving gastrectomy (PAFPG).Those of 11 normal subjects were examined likewise to serve as control.It was found that:(1) The average LPO levelwas much higher and the average SOD-Ⅰ level much lower in the gastric mucosa of the patientsafter conventional subtotal gastrectomy especially the Billroth Ⅱ type than in that of those afterPAFPG.(2) In 36 specimens of stump mucosa,the average LPO level was significantly higher inthe tissue around the anastomotic ring than in that of the body of the stump;no marked differ-ence of SOD-Ⅰ level between the 2 was revealed.(3) The LPO value in the stump mucosa waspositively correlated to and the SOD-Ⅰ value negatively correlated to the pH value of gastric juice.These rindings suggest that the reation of oxygen free radicals in the stump mucosa may be influ-enced by the intragastric pH or by the type of digestive continuity reconstruction,and that thereaction of oxygen free radicals especially the lipid peroxidation may play a role in the pathogenesisof the lesions in the anastomotic stoma.     

碱性反流液对残胃粘膜损伤机理的研究现状

1881年外科大师Uillroth设计了胃大部切除术式并成功地应用于临床。因疗效肯定,国内外沿用迄今已百余年。由于术后胃正常解剖结构的部分破坏,致使十二指肠内容物返流人胃引起不同程度的残胃粘膜损伤。这一公认的弊端始终未获满意的解决,     

保留幽门、胃窦浆肌瓣式胃次全切除术后近期胃运动功能的实验研究

为了克服传统胃次全切除术存在的胃肠动力功能紊乱,我们设计的保留幽门;胃窦浆肌瓣式胃的全切除术(Pylorusand Antroseromuscular FlapPreserv-ing Subtotal Gastrectomy、PAFPG)经临床应用,效果较满意.本研究在建立不同胃手术大模型基础上,通