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近端胃迷走神经切断术与西咪替丁长期维持治疗慢性十二指肠溃疡:一项前瞻性随机试验。

Proximal gastric vagotomy versus long-term maintenance treatment with cimetidine for chronic duodenal ulcer: a prospective randomised trial.

作者信息

Gear M W

出版信息

Br Med J (Clin Res Ed). 1983 Jan 8;286(6359):98-9. doi: 10.1136/bmj.286.6359.98.

DOI:10.1136/bmj.286.6359.98
PMID:6401510
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1546422/
Abstract

Forty-four patients with chronic duodenal ulceration were allocated randomly to either long-term maintenance treatment with cimetidine or proximal gastric vagotomy. All were followed up both clinically and endoscopically for periods of one to four years. The rate of recurrence of ulcer during and after medical treatment was 54% while after surgery it was 10%. One patient developed severe allergic hepatitis while receiving maintenance treatment with cimetidine, and two others had to stop treatment because of possible drug reactions. Patients whose ulceration recurs while they are receiving treatment with cimetidine should be offered the possibility of operation.

摘要

44例慢性十二指肠溃疡患者被随机分为两组,一组接受西咪替丁长期维持治疗,另一组接受近端胃迷走神经切断术。所有患者均接受了为期1至4年的临床和内镜随访。药物治疗期间及治疗后的溃疡复发率为54%,而手术后的复发率为10%。1例患者在接受西咪替丁维持治疗时发生了严重的过敏性肝炎,另外2例患者因可能的药物反应而不得不停止治疗。接受西咪替丁治疗时溃疡复发的患者应考虑手术治疗。

相似文献

1
Proximal gastric vagotomy versus long-term maintenance treatment with cimetidine for chronic duodenal ulcer: a prospective randomised trial.近端胃迷走神经切断术与西咪替丁长期维持治疗慢性十二指肠溃疡:一项前瞻性随机试验。
Br Med J (Clin Res Ed). 1983 Jan 8;286(6359):98-9. doi: 10.1136/bmj.286.6359.98.
2
Cimetidine treatment of recurrent ulcer after proximal gastric vagotomy.
Scand J Gastroenterol. 1981;16(7):891-6. doi: 10.3109/00365528109181819.
3
Cimetidine for recurrent ulcer after vagotomy or gastrectomy: a randomised controlled trial.西咪替丁用于迷走神经切断术或胃切除术后复发性溃疡:一项随机对照试验。
Br Med J. 1978 May 13;1(6122):1242-3. doi: 10.1136/bmj.1.6122.1242.
4
Vagotomy in the cimetidine era.
Ann Chir Gynaecol. 1983;72(1):1-2.
5
Failure of proximal gastric vagotomy for duodenal ulcer resistant to cimetidine.近端胃迷走神经切断术治疗对西咪替丁耐药的十二指肠溃疡失败。
Lancet. 1984 Jul 14;2(8394):84-6. doi: 10.1016/s0140-6736(84)90251-4.
6
Proximal gastric vagotomy in patients resistant to cimetidine.西咪替丁治疗无效患者的近端胃迷走神经切断术
Br J Surg. 1985 Mar;72(3):177-8. doi: 10.1002/bjs.1800720305.
7
[Proximal gastric vagotomy; effect on parietal and non-parietal components of gastric secretion. Comparison with effects obtained with cimetidine].[近端胃迷走神经切断术;对胃分泌壁细胞和非壁细胞成分的影响。与西咪替丁的作用比较]
Rev Esp Enferm Apar Dig. 1981 Aug;60(2):137-48.
8
Cimetidine or parietal-cell vagotomy in patients with juxtapyloric ulcers.
Lancet. 1984 Oct 20;2(8408):894-7. doi: 10.1016/s0140-6736(84)90655-x.
9
H2-antagonists in the treatment of recurrent ulceration after vagotomy.H2拮抗剂在迷走神经切断术后复发性溃疡治疗中的应用
Br J Surg. 1979 Jun;66(6):409-11. doi: 10.1002/bjs.1800660611.
10
Maintenance treatment of duodenal ulcer patients with a single bedtime dose of cimetidine.十二指肠溃疡患者每晚睡前单次服用西咪替丁进行维持治疗。
Scand J Gastroenterol. 1979;14(7):827-31. doi: 10.3109/00365527909181411.

引用本文的文献

1
The surgical treatment of peptic ulcer disease. A physician's view.消化性溃疡疾病的外科治疗。医生的观点。
Dig Dis Sci. 1985 Nov;30(11 Suppl):52S-54S. doi: 10.1007/BF01309385.
2
Recurrent peptic ulcers.复发性消化性溃疡
World J Surg. 1987 Jun;11(3):274-82. doi: 10.1007/BF01658103.
3
Should it be parietal cell vagotomy or selective vagotomy-antrectomy for treatment of duodenal ulcer? A progress report.治疗十二指肠溃疡应采用壁细胞迷走神经切断术还是选择性迷走神经切断术-胃窦切除术?一份进展报告。
Ann Surg. 1987 May;205(5):572-90. doi: 10.1097/00000658-198705000-00017.
4
[Initial interventions in ulcer disease: indications--choice of procedure--results].[溃疡病的初始干预措施:适应证——手术选择——结果]
Langenbecks Arch Chir. 1987;372:173-9. doi: 10.1007/BF01297812.
5
Current status of proximal gastric vagotomy.近端胃迷走神经切断术的现状
Ann Surg. 1989 Feb;209(2):131-48. doi: 10.1097/00000658-198902000-00001.
6
Long term treatment of duodenal ulcer. A review of management options.十二指肠溃疡的长期治疗。管理选项综述。
Drugs. 1991 Jan;41(1):38-51. doi: 10.2165/00003495-199141010-00004.
7
Laparoscopic cholecystectomy.腹腔镜胆囊切除术
BMJ. 1992 Mar 21;304(6829):777. doi: 10.1136/bmj.304.6829.777.

本文引用的文献

1
Intermittent treatment of duodenal ulcer with cimetidine.西咪替丁间歇治疗十二指肠溃疡。
Br Med J. 1980 Jul 5;281(6232):20-2. doi: 10.1136/bmj.281.6232.20.
2
Bedtime cimetidine maintenance treatment: optimum dose and effect on subsequent natural history of duodenal ulcer.睡前西咪替丁维持治疗:最佳剂量及对十二指肠溃疡后续自然病程的影响。
Gut. 1982 Mar;23(3):239-42. doi: 10.1136/gut.23.3.239.
3
Does treatment with cimetidine extended beyond initial healing of duodenal ulcer reduce the subsequent relapse rate?西咪替丁治疗十二指肠溃疡,在溃疡初步愈合后继续用药,能否降低后续复发率?
Br Med J (Clin Res Ed). 1982 Feb 27;284(6316):621-3. doi: 10.1136/bmj.284.6316.621.
4
Peptic ulcer surgery: selection for operation by 'earning'.消化性溃疡手术:通过“获益”来选择手术方式
Gut. 1969 Dec;10(12):996-1003. doi: 10.1136/gut.10.12.996.
5
Operative mortality and postoperative morbidity of highly selective vagotomy.高选择性迷走神经切断术的手术死亡率和术后发病率。
Br Med J. 1975 Dec 6;4(5996):545-7. doi: 10.1136/bmj.4.5996.545.
6
Proximal gastric vagotomy: interim results of a randomized controlled trial.
Br Med J. 1975 May 10;2(5966):301-3. doi: 10.1136/bmj.2.5966.301.
7
Survival in peptic ulcer.消化性溃疡的生存率
Gastroenterology. 1978 Dec;75(6):1055-60.
8
Prophylactic effect of cimetidine in duodenal ulcer disease.西咪替丁在十二指肠溃疡病中的预防作用。
Br Med J. 1978 Apr 29;1(6120):1095-7. doi: 10.1136/bmj.1.6120.1095.