Bereznyts'kyĭ Ia S, Snisar A V, Haĭdar Iu A
Klin Khir. 2010 May(5):11-4.
There were examined 35 patients after performance of operations for complicated ulcer disease. To the first group were incorporated 9 (25.7%) patients, in whom palliative operations were done, to the second group--9 (25.7%) patients, to whom vagotomy with gastric drainage operation was performed, and to the third group--17 (48.6%) patients, in whom gastric resections were applied. After palliative operations patholologic mucosal changes were localized predominantly in gastric antrum and duodenal ampulla. In 89% of observations mucosal pathology was associated with H. pylori. In 77.8% of the examined patients of second group the mucosal contamination by H. pylori was revealed. The relation was determined between gastric antrum mucosal inflammation and H. pylori infectioning. After gastric resection more significant signs of mucosal inflammation were observed in gastric stump and anastomotic region in comparison with such in efferent intestinal loop. Studying of gastroduodenal mucosa, using histological investigations after surgical treatment of complicated ulcer disease permits to reveal the character of mucosal pathological changes after performance of various operations and, taking it to account, to elaborate the individualized program of the patients rehabilitation.
对35例复杂性溃疡病手术后的患者进行了检查。第一组纳入9例(25.7%)患者,他们接受了姑息性手术;第二组纳入9例(25.7%)患者,他们接受了迷走神经切断术加胃引流手术;第三组纳入17例(48.6%)患者,他们接受了胃切除术。姑息性手术后,病理黏膜改变主要位于胃窦和十二指肠壶腹。在89%的观察中,黏膜病理与幽门螺杆菌有关。在第二组77.8%的受检患者中发现了幽门螺杆菌对黏膜的污染。确定了胃窦黏膜炎症与幽门螺杆菌感染之间的关系。胃切除术后,与输出肠袢相比,胃残端和吻合口区观察到更明显的黏膜炎症迹象。对复杂性溃疡病进行手术治疗后,通过组织学研究对胃十二指肠黏膜进行研究,有助于揭示各种手术后黏膜病理变化的特征,并据此制定患者康复的个体化方案。