Weaver R M, Temple J G
Br J Surg. 1985 Mar;72(3):177-8. doi: 10.1002/bjs.1800720305.
Fifty-seven patients, with chronic duodenal ulceration resistant to cimetidine therapy, underwent proximal gastric vagotomy during the period August 1979 to May 1984. Thirty-five failed to respond to cimetidine in a dose of 1 g/day, whilst 22 relapsed on reduction of dosage to 400 mg daily or on cessation of therapy. Forty have been followed up for a period of 12-53 months (median duration = 28.5 months), and assessed using the modified Visick system. Thirty-four patients (85 per cent) were graded Visick I or II. Four patients (10 per cent) had non-specific upper gastrointestinal symptoms (Visick III). In these patients endoscopy has shown no evidence of recurrent ulceration. Two patients (5 per cent) were graded Visick IV. One had recurrent ulceration on endoscopy. The other developed symptomatic gastro-oesophageal reflux, necessitating further surgery. These results support the view that cimetidine resistance is not a predictor of poor results following proximal gastric vagotomy.
1979年8月至1984年5月期间，57例对西咪替丁治疗耐药的慢性十二指肠溃疡患者接受了近端胃迷走神经切断术。35例患者对每日1克剂量的西咪替丁无反应，而22例在剂量减至每日400毫克或停止治疗后复发。40例患者接受了12 - 53个月的随访（中位持续时间 = 28.5个月），并使用改良的维西克（Visick）系统进行评估。34例患者（85%）被评为维西克I级或II级。4例患者（10%）有非特异性上消化道症状（维西克III级）。在这些患者中，内镜检查未发现复发性溃疡的证据。2例患者（5%）被评为维西克IV级。1例在内镜检查时有复发性溃疡。另1例出现有症状的胃食管反流，需要进一步手术。这些结果支持这样一种观点，即对西咪替丁耐药并不是近端胃迷走神经切断术后预后不良的预测指标。
