Włodarczyk A, Bielecki K, Tałałaj M, Marcinowska-Suchowierska E, Zawadzki J, Ciok M, Gajda A, Brzozowski R
Department of General Surgery, Medical Centre of Postgraduate Education, Warsaw, Poland.
Mater Med Pol. 1994 Jan-Mar;26(1):13-6.
Surgical treatment of peptic ulcer may lead to several late postoperative morphological and metabolic abnormalities. Forty two patients (16 females and 26 males) at mean age of 47 years after surgery for peptic ulcer (mean postoperative period of 9 years) were recruited in this study. Following methods have been used for evaluation of those patients: clinical and serum biochemical assessment, UGI tract endoscopy, histology of gastric or duodenal mucosa biopsies, test for H-pylori presence, Ca-P-Mg homeostasis and BMD using DXA-absorptiometry. No clinical and biochemical abnormalities were found. In 60% of examined pts gastritis or duodenitis with various degrees of the reflux were found endoscopicaly. In 64% of pts histology showed signs of mucosal inflammation. Recurrent ulcer was found in 3 pts. H-pylori was present in 16 pts (40%). The significant reduction of BMD, especially of the lumbar spine, in the pts after the PG resection in comparison to the pts with the vagotomy was found. Within several years after gastric operation the patient must be carefully evaluated and adequate supplementation of Ca and vitamin D is strongly recommended.
消化性溃疡的手术治疗可能会导致一些术后晚期的形态和代谢异常。本研究招募了42例消化性溃疡手术后的患者（16例女性，26例男性），平均年龄47岁，平均术后时间9年。对这些患者采用了以下评估方法：临床和血清生化评估、上消化道内镜检查、胃或十二指肠黏膜活检组织学检查、幽门螺杆菌检测、采用双能X线吸收法测定钙-磷-镁稳态和骨密度。未发现临床和生化异常。60%的受检患者内镜检查发现不同程度反流性胃炎或十二指肠炎。64%的患者组织学显示黏膜炎症迹象。3例患者发现复发性溃疡。16例患者（40%）存在幽门螺杆菌。与迷走神经切断术患者相比，胃部分切除术后患者的骨密度显著降低，尤其是腰椎。胃手术后几年内必须对患者进行仔细评估，并强烈建议适当补充钙和维生素D。
