Pomelov V S, Baramidze G G
Khirurgiia (Mosk). 1994 May(5):32-5.
Postoperative reflux gastritis in persons who were operated on for peptic ulcer occurs much more frequently after resection of the stomach (68.6%) than after organ-preserving operations on the stomach (39.4%). The incidence of reflux gastritis after gastric resection depends on the type of gastroenteroanastomosis. It is encountered much less frequently after Roux' operation (9.2%). The pronounced character and frequency of reflux gastritis after organ-preserving operations on the stomach are determined by the type of stomach-draining operations, the localization of the ulcer before the operation, whether in the stomach or the duodenum, the existence of duodenogastric reflux (DGR) before the operation. Measures for the prevention of postoperative reflux gastritis in the management of peptic ulcer are as follows: (a) wide introduction of organ-preserving operations, preferably SPV by itself or in combination with duodenoplasty; (b) formation of Roux' gastroenteroanastomosis when resection of the stomach is indicated. Reflux gastritis must be treated by nonoperative methods, including medicinal, dietetic, and spa therapy. Surgery is indicated in reflux gastritis combined with other diseases of a stomach which had been operated on, for which an operation is necessary, and in occasional cases of erosive reflux gastritis.
因消化性溃疡接受手术的患者,术后反流性胃炎在胃切除术后(68.6%)的发生率远高于保胃手术(39.4%)。胃切除术后反流性胃炎的发生率取决于胃肠吻合术的类型。在Roux手术(9.2%)后其发生率要低得多。保胃手术后反流性胃炎的显著特征和发生率取决于胃引流手术的类型、术前溃疡的部位(在胃还是十二指肠)、术前是否存在十二指肠胃反流(DGR)。在消化性溃疡治疗中预防术后反流性胃炎的措施如下:(a)广泛开展保胃手术,最好单独进行SPV或与十二指肠成形术联合进行;(b)在有胃切除指征时采用Roux胃肠吻合术。反流性胃炎必须采用非手术方法治疗,包括药物、饮食和温泉疗法。对于合并有已手术胃的其他疾病且有手术必要的反流性胃炎,以及偶尔的糜烂性反流性胃炎病例,需进行手术治疗。