胃十二指肠良性疾病胃大部切除后远期随访观察

[目的]观察胃十二指肠良性疾病胃大部切除者的远期并发症、健康状况及与胃癌的关系，并探讨其手术指征。[方法]对66例因溃疡病、胃息肉、萎缩性胃炎等施胃大部分切除术后10年以上者进行随访复查，并对其并发症和目前健康状况作评估。[结果]66例均有不同程度的残胃炎，胆汁反流24例（36．3％），溃疡病10例（15．1％），营养不良9例（13．6％），贫血6例（9．1％），息肉和肠黏连各2例（3．0％），残胃癌3例（4．5％），食管癌1例（1．5％），大部分病例有1～3种重要并发症、合并症，生活质量明显下降。[结论]良性疾病作胃大部切除10年以上者，除均有残胃炎外，可并发胆汁反流、溃疡复发、营养不良等，发生癌变占6．1％。目前，对溃疡病等采用PPI治疗效佳、安全。因此，作胃大部切除的指征应严格掌握。

Long term follow-up of patients suffered from subtotal gastrectomy due to benign diseases of Gastroduodenal

[Objective]To investigate the long term complications and health condition of patients suffered from subtotal gastrectomy due to benign diseases of gastroduodenal, especially the relationship between gastric carcinoma and long term complications , as well as to investigate the indications for surgery, [Methods]Re-examination including gastroscope was made in 66 patients suffered from subtotal gastrectomy more than 10 years due to ulcer disease, gastric polyp and atrophic gastritis , and the complications , coexisting conditions and their current health condition was estimated.[Results]Sixty six patients all suffered from gastric stump inflammation in varying degrees,including 24 cases of bile reflux gastritis （36. 3 %）, 10 cases of ulcer disease （15. 1%）, 9 cases of malnutrition（13.6%） ,6 cases of anaemia（9. 1%）,2 cases of polyp and ankylenteron respectively（3.0%）. 3 cases of gastric stump cancer（4. 5%） and 1 case of esophageal carcinoma （1.5 %）. Most of the patients suffer from 1--3 significant coexisting conditions, and their quality of life declined. [Conclusion]Patients suffered from subtotal gastrectomy more than 10 years due to benign diseases of gastroduodenal will suffer from bile reflux gastritis ,ulcer recurring,malnutrition besides gastric stump inflammation , the occurrence canceration is 6. 1%, in addition to the coexisting conditions, the health condition is significantly influenced. As so far, patients suffering from ulcer disease treated with PPI has got a satisfied therapeutic effect. So the indications for surgery should be strictly controlled.