首页 | 本学科首页   官方微博 | 高级检索  
     

高选择性胃迷走神经切断术加保留幽门的胃窦粘膜切除术的应用
作者姓名:Yu P  Wang D  Cai Z  Wen Y
作者单位:400038,重庆,第三军医大学西南医院普通外科
摘    要:目的:观察高选择性胃迷走神经切断术加保留幽门的胃窦粘膜切除术(HSV PPMA)治疗十二指肠溃疡的远期疗效。方法:对1987年以来实施该手术后8-14年的34例患者进行了临床随访分析。结果:全组无手术死亡病例,临床属Visick分级Ⅰ-Ⅱ级者占94.1%。术后胃酸分泌及胃窦粘膜幽门螺杆菌感染率较术前有显著降低。血清胃泌素水平术后虽然较术前有所降低,但差异无显著性意义。术后胃液胆酸和细菌含量较术前相比无显著变化。胃排空均正常,X线钡餐和胃镜检查未发现溃疡复发。结论:HSV PPMA不仅能有效降低胃酸分泌,减少溃疡复发,而且能保存胃窦和幽门功能,防止术后胆汁反流和胃内细菌过度繁殖,是一种治疗十二指肠溃疡较理想的术式。

关 键 词:胃窦粘膜切除术  迷走神经切断术  十二指肠溃疡  胃酸  促胃液素  胆酸  幽门保留  HSV  PPMA
修稿时间:2002年2月26日

Long-term clinical results after highly selective vagotomy plus pylorus-preserved mucosal antrectomy
Yu P,Wang D,Cai Z,Wen Y.Long-term clinical results after highly selective vagotomy plus pylorus-preserved mucosal antrectomy[J].Chinese Journal of Surgery,2002,40(9):650-652.
Authors:Yu Peiwu  Wang Daike  Cai Zhimin  Wen Yayuan
Affiliation:Department of General Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Abstract:OBJECTIVE: To study the long-term clinical results of 34 chronic duodenal ulcer patients treated with high selective vagotomy plus pylorus-preserved mucosal antrectomy (HSV + PPMA). METHODS: Clinical follow-up results of the patients from 8 approximately 14 years were analyzed. RESULTS: Thirty-tow patients (94.1%) followed-up for 8 approximately 14 years after operation achieved Visick grades I-II. No patient died. Gastric acid secretion and infection rate of Helicobacter pylori in the antral mucosa were significantly reduced after operation. No significant difference was found in bile acids, total bacterial counts in gastric juice, and the level of serum gastrin after operation. Gastric emptying was normal. No ulcer recurrence was found by barium meal and endoscopy. CONCLUSIONS: HSV + PPMA is a better operative treatment for duodenal ulcer, which not only can decrease acid secretion and ulcer recurrence rate but also can preserve the function of antrum and pylorus and prevent post-operation bile reflux and intragastric bacterial overgrowth.
Keywords:Vagotomy  Duodenal ulcer  Gastric acid  Gastrin  Cholic acid
本文献已被 CNKI 维普 万方数据 PubMed 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号