Humphrey C S, Johnston D, Walker B E, Pulvertaft C N, Goligher J C
Br Med J. 1972 Sep 30;3(5830):785-8. doi: 10.1136/bmj.3.5830.785.
The incidence of dumping after truncal or selective vagotomy with pyloroplasty and highly selective vagotomy without a drainage procedure was assessed both clinically and experimentally. At a gastric follow-up clinic dumping was found to be significantly less frequent in patients who had undergone highly selective vagotomy without a drainage procedure than in patients who had undergone truncal or selective vagotomy with pyloroplasty (P < 0.05 or < 0.001, respectively). Hypertonic glucose given by mouth provoked the onset of dumping in 20% of patients with duodenal ulcer before operation, in 73% after truncal vagotomy and pyloroplasty, in 80% after selective vagotomy and pyloroplasty, and in 47% after highly selective vagotomy. The test meal also produced significantly greater decreases in blood pressure and increases in pulse rate in patients who had undergone vagotomy with pyloroplasty than in patients who had undergone highly selective vagotomy.
对行迷走神经干切断术或选择性迷走神经切断术加幽门成形术以及行高选择性迷走神经切断术而未行引流手术的患者,评估倾倒综合征的发生率,进行了临床和实验研究。在一家胃部随访诊所发现,行高选择性迷走神经切断术而未行引流手术的患者,倾倒综合征的发生频率明显低于行迷走神经干切断术或选择性迷走神经切断术加幽门成形术的患者(分别为P < 0.05或< 0.001)。术前,口服高渗葡萄糖可诱发20%的十二指肠溃疡患者出现倾倒综合征;行迷走神经干切断术加幽门成形术后,这一比例为73%;行选择性迷走神经切断术加幽门成形术后为80%;行高选择性迷走神经切断术后为47%。与行高选择性迷走神经切断术的患者相比,行迷走神经切断术加幽门成形术的患者在试餐时血压下降幅度和心率增加幅度也明显更大。