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[胃切除术治疗消化性溃疡患者的长期随访研究结果]

[Results of long follow-up study for peptic ulcer patients treated with gastrectomy].

作者信息

Nishiwaki H, Nishimori T, Teramura M, Satake K, Soma M, Umeyama K

机构信息

First Department of Surgery, Osaka-city University Medical School, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 1988 Nov;89(11):1789-95.

PMID:3205248
Abstract

This clinical study was based on 307 peptic ulcer patients treated with gastrectomy over a 15-year period in our department. Numbers of surgical cases for peptic ulcer remarkably decreased after the introduction of cimetidine in 1980. A median age of gastric ulcer patients was in sixth decades, whereas duodenal ulcer in fifth decades. Surgical indications were 60 percent in intractable ulcer, 30 percent in complication as bleeding, stenosis and perforation, and 10 percent in suspicious malignancy. After cimetidine introduction intractable cases decreased from 63 percent to 44 percent. There was no remarkable difference in the fasting and peak plasma secretin concentrations in postprandial period between peptic ulcer patients and normal controls, however, in gastrectomized patients the plasma secretin response decreased in postprandial state. Follow up study was made on a point of postoperative recurrence and postgastrectomy syndrome. Small stomach syndromes such as insufficient food intake and body weight loss were observed in 10 and 30 percent in the gastrectomized patients, but 86 percent of the patients were satisfied with the results of operation. We concluded that gastrectomy for peptic ulcer was treatment of choice from the point of low recurrence rate and no severe postgastrectomy disorders.

摘要

本临床研究基于我院15年间接受胃切除术治疗的307例消化性溃疡患者。1980年西咪替丁应用后,消化性溃疡手术病例数显著减少。胃溃疡患者的中位年龄为六旬,而十二指肠溃疡患者为五旬。手术指征为:难治性溃疡占60%,出血、狭窄和穿孔等并发症占30%,可疑恶性肿瘤占10%。西咪替丁应用后,难治性病例从63%降至44%。消化性溃疡患者与正常对照组餐后空腹及血浆促胰液素峰值浓度无显著差异,然而,胃切除术后患者餐后血浆促胰液素反应降低。对术后复发和胃切除术后综合征进行了随访研究。胃切除术后患者中,分别有10%和30%出现如进食不足和体重减轻等小胃综合征,但86%的患者对手术结果满意。我们得出结论,从低复发率和无严重胃切除术后疾病的角度来看,胃切除术是消化性溃疡的首选治疗方法。

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