Kuzin N M, Alimov A N, Gordeev V F, Maíorova I B
Faculty Surgical Hospital of NN Burdenko.
Khirurgiia (Mosk). 1997(8):28-31.
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.
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。
