摘要
目的 评价改良高选择性迷走神经切断术治疗十二指肠溃疡穿孔患者的疗效。方法用吻 (缝 )合器行胃小弯迷走神经切断加胃底折叠钉合浆肌层切开术治疗十二指肠溃疡穿孔患者 48例 ,并与同期十二指肠溃疡穿孔行单纯缝合修补术 37例患者对比分析。结果 二组病例术后 5 肽胃泌素胃酸分泌试验 :基础排酸量 (baseacidoutput,BAO)、最大排酸量 (maximumacidoutput,MAO)、高峰排酸量 (peakacidoutput,PAO)分别为 (1 6 7± 1 2 8)mmol/h、(7 5 3± 3 6 9)mmol/h、(11 0 6± 4 2 3)mmol/h、(6 6 8± 2 2 3)mmol/h、(2 4 41± 6 18)mmol/h和 (32 72± 12 2 5 )mmol/h。随访率 10 0 % ,随访 3个月至 7年 ,中位随访时间 3年 9个月。治疗组无 1例复发。对照组复发 11例 (30 % ) ,再次手术 4例(10 8% )。治疗效果按改良Visick分级 :Ⅰ、Ⅱ级治疗组达 94% ,对照组为 5 1%。结论 改良高选择性迷走神经切断术治疗十二指肠溃疡穿孔具有迷走神经切断彻底、操作简捷、并发症少。疗效优于单纯缝合修补术。
Objective To evaluate the effect of modified highly selective vagotomy for the treatment of perforated duodenal ulcer.[WT5”HZ] Methods[WT5”BZ] 48 cases of perforated duodenal ulcer underwent modified highly selective vagotomy with lesser curvature vagotomy and seromyotomy plus fundus stapling. Results were compared with that of 37 cases treated with simple suture of the perforation.[WT5”HZ] Results[WT5”BZ] With postoperative pentagastrin stimulation, the base acid output (BAO)、maximum acid output(MAO) and peak acid output(PAO) were (1 67±1 28)?mmol/h and (7 53±3 69)?mmol/h and (11 06±4 23) ?mmol/h in the former, and (6 68±2 23)?mmol/h、(24 41±6 18)?mmol/h and (32 72±12 25)?mmol/h in the later. All patients were followed up from 3 months to seven years. There was no ulcer recurrence in the therapy groups.Recurrence was found in 11 cases in the suture groups during a mean follow up period of 39 months. Using a modified Visick grading, 94% of patients were classified as Ⅰ and Ⅱ in the therapy groups and 51% in the comparison groups.[WT5”HZ] Conclusions[WT5”BZ] The modified highly selective vagotomy is an easy and rapid procedure with less complications and complete vagotomy.
出处
《中华普通外科杂志》
CSCD
2000年第10期614-616,共3页
Chinese Journal of General Surgery
