Li S, Chen P, An P, Liu C, Yuan S, Chen L
Department of Surgery, Beijing Army General Hospital.
Chin Med J (Engl). 1995 Dec;108(12):898-901.
Since 1979 we have treated 149 patients with duodenal ulcer by extended parietal cell vagotomy (EPCV). Electron microscopy of parietal cells from gastric body mucosa and gastric acid secretory test were carried out in 22 randomly selected patients before and after EPCV. It was shown that before EPCV the ultrastructure of parietal cells presented the feature of vigorous section identical to the hyperfunctional secretion of gastric acid. The ultrastructure of parietal cells presented the feature of acute depression of secretory function, which was identical to a significant reduction of secretory function of gastric acid 0.5-6 months after EPCV. Two to 10 years after operation, however, especially over 10 years after EPCV, the ultrastructural changes of parietal cells gradually returned to normal, but gastric acid secretion remained at a low level, without preoperative secretory capacities. The results of this study provide a histological basis for the application of extended parietal cell vagotomy in the treatment of duodenal ulcer and its complications.
自1979年以来，我们采用扩大壁细胞迷走神经切断术（EPCV）治疗了149例十二指肠溃疡患者。在22例随机选择的患者中，于EPCV术前及术后进行了胃体黏膜壁细胞的电子显微镜检查和胃酸分泌试验。结果显示，EPCV术前壁细胞的超微结构呈现出与胃酸高分泌功能相一致的活跃分泌特征。壁细胞的超微结构呈现出分泌功能急性抑制的特征，这与EPCV术后0.5至6个月胃酸分泌功能显著降低相一致。然而，术后2至10年，尤其是EPCV术后10年以上，壁细胞的超微结构变化逐渐恢复正常，但胃酸分泌仍维持在低水平，未恢复到术前的分泌能力。本研究结果为扩大壁细胞迷走神经切断术治疗十二指肠溃疡及其并发症的应用提供了组织学依据。
