摘要
目的 研究选择性迷走神经切断加胃窦切除术 (SV +A)治疗十二指肠溃疡远期疗效。方法 1 977年 1 1月～ 2 0 0 1年 1 1月采用SV +A治疗 1 93例十二指肠溃疡患者 ,其中顽固性溃疡 2 8例 ,溃疡伴出血 1 1 2例 ,溃疡伴幽门梗阻 41例 ,胃十二指肠复合性溃疡 1 2例。 结果 SV +A术后及术后随访基础胃酸分泌 (BAO)、胰岛素刺激后胃酸分泌 (IMAO)、五肽胃泌素刺激后胃酸分泌 (PMAO)和血清胃泌素显著下降 ,壁细胞呈现分泌抑制的特征 ;术后 1～ 1 0年和 1 1～ 2 4年的随访 ,患者属于VisickⅠ、Ⅱ级分别占 95 60 %和 96 61 % ,Ⅲ级分别占 (4 40 % )和 (3 39% ) ,无溃疡复发。 结论SV +A降酸显著而特久 ,无溃疡复发。该术式是手术治疗十二指肠溃疡特别是溃疡并发症的有效方法。
Objectives To study the long term results of selective vagotomy plus antrectomy in treatment of duodenal ulcer. Methods One hundred and ninety three patients with duodenal ulcer were subjected to selective vagotomy plus antrectomy from November 1977 to November 2001. These patients included 28 patients with refractory ulcer, 112 with recurrent bleeding, 41 with pylori obstruction, and 12 with duodenal and gastric ulcer. Results BAO, IMAO, PMAO and serum gastrin were decreased significantly after an 1 24 year follow up after selective vagotomy plus antrectomy. The characteristics of inhibitory secretive were observed in parietal cells. Follow up after operation for 1-10 years and 11-24 years showed that 95 60% and 96 61% of patients belonged to Visick grade Ⅰ and Ⅱ, and 4 40% and 3 39% of patients belonged to Visick grade Ⅲ, respectively. No ulcer recurrence was seen during the 1-24 year follow up after the operation. Conclusion SV+A is an effective method for duodenal ulcer, especially for complicated duodenal ulcer, with permanent reduction of gastric acid and no recurrence.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2002年第11期834-837,共4页
Chinese Journal of Surgery
