残胃病变846例内镜及临床表现

目的：探讨胃部分切除术后残胃病变的发病学特点。方法：回顾性分析我院1980年至2001年20年间846例胃部分切除术后患的内镜资料及临床表现。结果：残胃病变中以残胃炎及吻合口炎最常见，占89．2％，其次为胆汁反流，占58．5％，再次为残胃及吻合口溃疡，占16．9％；残胃癌的发生率为4．8％。此外还有食管贲门炎，缝线残留等。残胃病变的临床表现主要为上腹部疼痛占60．3％，恶心、呕吐及／或纳差、消瘦占19．1％，呕血、黑便占11．3％。结论：为减少残胃病变，尤其是残胃癌的发生，要严格掌握胃切除的指征，而且手术后定期复查胃镜，早期发现残胃病变。

The endoscopic and clinical characteristics of 846 cases of gastric stump lesion

Objectives:To study the endoscopic and clinical characteristics of gastric stump lesion after partial gastrectomy.Methods:The endoscopic and clinical data of 846 cases of gastric stump lesion encountered in our hospital within past 20 years were analysed restrospectively.Results:The most common causes of gastric stump lesion was stumpitis and stomitis,the detecting rate was 89 2%.The second was bile reflux(58 5%),and the third was gastric stump and stoma ulcer(16 9%).The detecting rate of gastric stump cancer was 4 8%.The clinical characteristics of gastric stump lesion was:upper abdominal pain is 60 3%,nausea,vomiting and lack of appetite or loss weight is 19 2%,and hematemesis or black stool is 11 3%.Conclusion:The results suggest that strict indication of gastrectomy should be emphasized to reduce the causes of gastric stump lesion,especially gastric stump cancer,and long-term gastroscopy follow-up is necessary after partial gastrectomy in order to find the early stage of gastric stump lesion.