Kuzin N M, Kanadashvili O V, Maĭorova E M
Khirurgiia (Mosk). 2000(4):22-6.
Available are the results of surgical treatment of 90 patients with stenotic gastroduodenal ulcer in Burdenko Surgical Faculty Hospital of Sechenov Moscow Medical Academy between 1984 and 1985. 30 patients (study group) underwent stomach Roux-type resection. Truncal vagotomy with a stomach Bilroth-I resection was made in 20 control patients, after 20 control patients had a truncal vagotomy with pyloroplasty according to Heineke-Mikulicz, and 20 patients had selective proximal vagotomy with gastroduodenostomy by Joboulay (the third control group). Exocrine function of the pancreas was assessed by serum concentration of immunoreactive trypsin, endocrine function by fasting blood sugar, oral glucose tolerance and serum concentration of immunoreactive insulin. The authors came to the conclusion that exocrine function of the pancreas was equally damaged in patients with a Roux stomach resection, stem vagotomy with a stomach Bilroth-I resection and a stem vagotomy with pyloroplasty Heineke-Mikulicz. After selective proximal vagotomy a level of immunoreactive trypsin was normal. After a Roux stomach resection relative incompetence of basophil cells of the pancreas and long increase of insulin in the blood were observed but without influence on the glucose curve. The changes of glucose curve and level of immunoreactive insulin were similar in the control groups.
现提供1984年至1985年期间在莫斯科谢马什克医学院布尔坚科外科医院对90例胃十二指肠狭窄性溃疡患者进行手术治疗的结果。30例患者(研究组)接受了胃 Roux 式切除术。20例对照患者进行了迷走神经干切断术加胃毕罗 - I式切除术,另外20例对照患者根据海涅克 - 米库利奇法进行了迷走神经干切断术加幽门成形术,还有20例患者进行了乔布莱选择性近端迷走神经切断术加胃十二指肠吻合术(第三对照组)。通过免疫反应性胰蛋白酶的血清浓度评估胰腺的外分泌功能,通过空腹血糖、口服葡萄糖耐量和免疫反应性胰岛素的血清浓度评估内分泌功能。作者得出结论,在接受 Roux 胃切除术、迷走神经干切断术加胃毕罗 - I式切除术以及迷走神经干切断术加海涅克 - 米库利奇幽门成形术的患者中,胰腺的外分泌功能受到同等程度的损害。在选择性近端迷走神经切断术后,免疫反应性胰蛋白酶水平正常。在 Roux 胃切除术后,观察到胰腺嗜碱性细胞相对功能不全以及血液中胰岛素长期升高,但对血糖曲线无影响。对照组的血糖曲线和免疫反应性胰岛素水平变化相似。