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[选择性近端迷走神经切断术后复发性溃疡(10年结果)]

[Recurrent ulcers following selective proximal vagotomy (10 years' results)].

作者信息

Saenko V F, Dikusarov A V, Polinkevich B S, Vashchenko A E, Pustovit A A

出版信息

Klin Khir (1962). 1989(3):10-3.

PMID:2733352
Abstract

The results of selective proximal vagotomy (SPV) in 1266 patients were studied. In 778 (61.5%) SPV alone was performed, in 488 (38.5%)--SPV with drainage operation: Finney pyloroplasty--in 249 (51%), Heineke-Mikulicz pyloroplasty--in 77 (15.8%), Jaboulay gastroduodenostomy--in 75 (15.4%), anterior hemipylorectomy--in 49 (10%), other drainage operations--in 38 (7.8%). After isolated SPV, excellent and good results were noted in 81.5% of the patients, satisfactory--in 11.1%, unsatisfactory--in 7.4%; after SPV with drainage operation--in 87.7%, 9.6% and 2.7%, respectively. An ulcer recurrence after SPV was revealed in 58 (7.4%), after SPV with drainage operation--in 13 (2.7%) of the patients examined. In 90% of cases, an ulcer recurrence developed at the pyloroduodenal zone, in 10%--in the stomach. The incidence of ulcer recurrence was 8.7% after operations performed by surgeons, who had not enough experience with the SPV performance, and 4.4%--by experienced surgeons. In 46.5% of cases, in recurrent ulcer, the conservative treatment was performed, and the remaining patients underwent surgery (antrumectomy, revagotomy etc.).

摘要

对1266例患者的选择性近端迷走神经切断术(SPV)结果进行了研究。仅行SPV的有778例(61.5%),行SPV加引流手术的有488例(38.5%):芬尼幽门成形术——249例(51%),海涅克-米库利奇幽门成形术——77例(15.8%),雅布莱胃十二指肠吻合术——75例(15.4%),前半幽门切除术——49例(10%),其他引流手术——38例(7.8%)。单纯SPV术后,81.5%的患者效果为优或良,11.1%为满意,7.4%为不满意;SPV加引流手术后,分别为87.7%、9.6%和2.7%。接受检查的患者中,SPV术后溃疡复发的有58例(7.4%),SPV加引流手术后有13例(2.7%)。90%的病例中,溃疡复发发生在幽门十二指肠区,10%发生在胃。经验不足的外科医生进行手术的溃疡复发率为8.7%,经验丰富的外科医生为4.4%。46.5%的复发性溃疡病例采用保守治疗,其余患者接受手术(胃窦切除术、再次迷走神经切断术等)。

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