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胃切除术后的Roux-Y淤滞综合征

Roux-Y stasis syndrome after gastrectomy.

作者信息

Gustavsson S, Ilstrup D M, Morrison P, Kelly K A

机构信息

Department of Surgery, Mayo Clinic, Rochester, Minnesota 55905.

出版信息

Am J Surg. 1988 Mar;155(3):490-4. doi: 10.1016/s0002-9610(88)80120-x.

Abstract

The aim of the present study was to determine which factors lead to upper gastrointestinal stasis after Roux-Y reconstruction. Among the 214 patients with Roux-Y reconstructions performed between 1961 and 1983, follow-up data were obtained for 187 (87 percent) after a mean of 6.2 years. Patients with vomiting of food but not bile, postprandial pain, and nausea were considered to have the Roux-Y stasis syndrome. The syndrome was found in 49 patients with gastrojejunostomy (30 percent of those at risk) but in only 2 patients with esophagojejunostomy (8 percent, p less than 0.05). The condition was more common in women than men (p less than 0.05), but it was equally common in patients with and without vagotomy. The mean length of the Roux-Y limb in patients with stasis was 41 cm, which was longer than the 36 cm in patients without stasis (p less than 0.001). When multiple logistic regression was used, the length of the Roux-Y limb emerged as the major risk factor (p less than 0.01). In conclusion, construction of Roux-Y limbs greater than about 40 cm in length may increase the incidence of the Roux-Y stasis syndrome.

摘要

本研究的目的是确定哪些因素会导致Roux-Y重建术后上消化道淤滞。在1961年至1983年间接受Roux-Y重建术的214例患者中,平均6.2年后获得了187例(87%)患者的随访数据。有食物呕吐但无胆汁、餐后疼痛和恶心的患者被认为患有Roux-Y淤滞综合征。该综合征在49例胃空肠吻合术患者中出现(占风险患者的30%),但在仅2例食管空肠吻合术患者中出现(8%,p<0.05)。该情况在女性中比男性更常见(p<0.05),但在有迷走神经切断术和无迷走神经切断术的患者中同样常见。淤滞患者的Roux-Y肠袢平均长度为41cm,比无淤滞患者的36cm长(p<0.001)。当使用多因素logistic回归分析时,Roux-Y肠袢长度成为主要危险因素(p<0.01)。总之,构建长度大于约40cm的Roux-Y肠袢可能会增加Roux-Y淤滞综合征的发生率。

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