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壁细胞迷走神经切断术后十年的一百名患者。

One hundred patients ten years after parietal cell vagotomy.

作者信息

Staël von Holstein C, Graffner H, Oscarson J

出版信息

Br J Surg. 1987 Feb;74(2):101-3. doi: 10.1002/bjs.1800740209.

Abstract

One hundred patients with duodenal or pyloric/prepyloric ulcer disease were operated with parietal cell vagotomy (PCV) and followed for a minimum of 10 years. At 6 weeks, 1,5 and 10 years postoperatively gastric secretory tests, haematological work-up and clinical examination or telephone interview were performed. There was no operative mortality and the frequency of postoperative sequelae was minimal. The cumulative ulcer recurrence rate was 18 per cent and another 14 per cent had slight to moderate symptoms of epigastric pain without any signs of ulcer. Upper gastrointestinal endoscopy was used to reveal recurrences but was performed only if the patient had symptoms of recurrence. A rise in basal acid secretion and in pentagastrin-stimulated secretion was observed the first year postoperatively, whereas insulin-stimulated peak acid output increased during the first 5 years. We conclude that PCV has a low rate of per- and postoperative complications and an acceptable recurrence rate. Therefore, it seems that PCV is the method of choice in chronic duodenal ulcer disease.

摘要

100例十二指肠或幽门/幽门前溃疡病患者接受了壁细胞迷走神经切断术(PCV),并至少随访10年。术后6周、1年和10年进行胃分泌功能测试、血液学检查以及临床检查或电话随访。无手术死亡,术后并发症发生率极低。溃疡累积复发率为18%,另有14%有轻度至中度上腹部疼痛症状但无溃疡迹象。采用上消化道内镜检查以发现复发情况,但仅在患者有复发症状时才进行。术后第一年观察到基础胃酸分泌和五肽胃泌素刺激分泌增加,而胰岛素刺激的最大胃酸分泌量在前5年增加。我们得出结论,PCV的围手术期和术后并发症发生率较低,复发率可以接受。因此,PCV似乎是慢性十二指肠溃疡病的首选治疗方法。

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