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迷走神经切断术后的碱性反流性胃炎

Postoperative alkaline reflux gastritis following vagotomy.

作者信息

Charitopoulos N C, Karkanias G G, Dimitraki T V, Papadimitriou C, Golematis B C

机构信息

Endoscopy Unit-First Propaedeutic Surgical Clinic, University of Athens Medical School, Greece.

出版信息

Hepatogastroenterology. 1994 Dec;41(6):542-5.

PMID:7721240
Abstract

This study was undertaken to evaluate the incidence and severity of postoperative alkaline reflux gastritis in 798 symptomatic duodenal ulcer patients who had undergone vagotomy. The condition was identified on the basis of the unique endoscopic and histological findings in 116 (14.5%) of them. It was more frequent and severe in patients with truncal vagotomy and gastrojejunostomy than in those with truncal vagotomy and pyloroplasty, while it was not at all observed in cases with proximal gastric vago-tomy, the symptoms depended on the preoperative history of the ulcer disease and the patient's age at the time of surgery, but did not always correspond with the degree of histological findings. The location of the gastrojejunostomy and the size of the pyloroplasty stoma had an influence on the incidence of the syndrome. Helicobacter pylori was found more frequently in biopsy specimens from patients with severe symptoms (30.3%), but was present in only 14.6% of the total number of the patients with postoperative alkaline reflux gastritis after vagotomy.

摘要

本研究旨在评估798例有症状的十二指肠溃疡患者行迷走神经切断术后碱性反流性胃炎的发生率和严重程度。根据独特的内镜和组织学表现,在其中116例(14.5%)患者中确诊了该疾病。与行迷走神经干切断术和幽门成形术的患者相比,行迷走神经干切断术和胃空肠吻合术的患者中该疾病更常见且更严重,而在近端胃迷走神经切断术的病例中未观察到该疾病,症状取决于溃疡病的术前病史和手术时患者的年龄,但并不总是与组织学表现程度相符。胃空肠吻合术的位置和幽门成形术吻合口的大小对该综合征的发生率有影响。在症状严重的患者活检标本中更频繁地发现幽门螺杆菌(30.3%),但在迷走神经切断术后碱性反流性胃炎患者总数中仅占14.6%。

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