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[十二指肠溃疡性狭窄患者在接受各类手术后的胃分泌、排空功能及十二指肠胃反流情况]

[Secretion, evacuation function of stomach and duodenogastric reflux in patients with ulcerative stenosis of duodenum after various type of operations].

作者信息

Kuzin N M, Alimov A N, Gordeev V F, Maíorova I B

机构信息

Faculty Surgical Hospital of NN Burdenko.

出版信息

Khirurgiia (Mosk). 1997(8):28-31.

PMID:9480375
Abstract

The results of surgical treatment of 118 patients with ulcerative disease of the duodenum, complicated by stenosis, were studied. 58 from them (49.2%) underwent selective proximal vagotomy (SPV) with duodenoplasty and 60 (50.8%) patients--SPV with gastroduodenoanastomosis by Zhabuley. In the early and long-term periods lowering of the audio productive function of the stomach was observed both in patients after SPV with duodenoplasty and after SPV with gastroduodenoanastomosis by Zhabuley. According to X-ray examination data in the long-term period after SPV with duodenoplasty the regular evacuation function has been restored in 95.5% of patients, and after SPV with gastroduodenoanastomosis--in 52.2% of patients the acceleration of evacuation was detected. The radionuclear examination after SPV with duodenoplasty manifested evacuation curves characteristic for healthy people in 93.3% of patients, and after SPV with gastroduodenoanastomosis--in 84% of patients the acceleration of the evacuation of various degrees, was revealed. The duodenogastral reflux (DGR) in long-term periods after SPV with duodenoplasty was revealed in 25% of patients, in most cases being periodic (18.8%). After SPV with gastroduodenoanastomosis DGR was registered almost 3 times more frequently (73.3%); permanent DGR was revealed in 46.7% of cases.

摘要

对118例十二指肠溃疡性疾病合并狭窄患者的手术治疗结果进行了研究。其中58例(49.2%)接受了选择性近端迷走神经切断术(SPV)并十二指肠成形术,60例(50.8%)患者接受了Zhabuley式选择性近端迷走神经切断术并胃十二指肠吻合术。在早期和长期观察中,接受SPV并十二指肠成形术以及接受Zhabuley式SPV并胃十二指肠吻合术的患者均出现胃听觉功能下降。根据X线检查数据,SPV并十二指肠成形术后长期随访,95.5%的患者恢复了正常排空功能,而SPV并胃十二指肠吻合术后,52.2%的患者发现排空加速。SPV并十二指肠成形术后的放射性核素检查显示,93.3%的患者的排空曲线具有健康人的特征,而SPV并胃十二指肠吻合术后,84%的患者出现不同程度的排空加速。SPV并十二指肠成形术后长期随访发现,25%的患者存在十二指肠胃反流(DGR),大多数情况为周期性反流(18.8%)。SPV并胃十二指肠吻合术后DGR的发生率几乎高出3倍(73.3%);46.7%的病例存在持续性DGR。

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