Abraham P, Menezes R A, Bhatt C B, Pipalia D H, Patel K C
Indian J Gastroenterol. 1989 Jul;8(3):145-7.
Gastric acid response to modified sham feeding was evaluated in 14 patients with duodenal ulcer prior to vagotomy and in 18 patients after vagotomy. Nine patients in the latter group had recurrent ulcer, suggesting inadequate vagotomy. Based on values in the 32 tests (14 pre and 18 postoperative), cut-off levels of six secretory indices were selected to provide a specificity of 1.00 for the presence of ulcer. When applied separately to the 18 postoperative patients and to the 13 patients who underwent the endoscopic congo red test, observed volume of 75 ml/h and peak volume of 90 ml/h following sham feeding gave specificity, sensitivity and efficiency of 1.00 each in determining inadequate vagotomy. The endoscopic congo red test done in 13 post-vagotomy cases showed a sensitivity of 1.00, and high specificity (0.89) and efficiency (0.92). Measurement of crude gastric juice response to modified sham feeding is a convenient bedside test to confirm inadequate vagotomy. The endoscopic congo red test is also useful, especially as a screening test, and has the added advantage that it can be used intra-operatively.
在14例十二指肠溃疡患者迷走神经切断术前和18例迷走神经切断术后患者中评估了胃酸对改良假饲的反应。后一组中有9例患者出现复发性溃疡，提示迷走神经切断不完全。根据32次检测（14例术前和18例术后）的数值，选择六个分泌指标的临界值，以使溃疡存在的特异性为1.00。当分别应用于18例术后患者和13例接受内镜刚果红试验的患者时，假饲后观察到的75毫升/小时的容量和90毫升/小时的峰值容量在确定迷走神经切断不完全方面的特异性、敏感性和效率均为1.00。在13例迷走神经切断术后病例中进行的内镜刚果红试验显示敏感性为1.00，特异性高（0.89），效率高（0.92）。测量粗胃液对改良假饲的反应是一种方便的床边试验，可用于确认迷走神经切断不完全。内镜刚果红试验也很有用，特别是作为一种筛查试验，并且具有可在术中使用的额外优势。
