摘要
目的对98例胃十二指肠溃疡病人施行保留幽门及胃窦浆肌瓣胃次全切除术(简称PAFPG),拟解决胃次全切除术所存在的倾倒、返流和滞留三个胃动力学问题。方法通过保留胃迷走神经及幽门和制备胃窦“舌形”浆肌瓣来保留幽门及胃窦的功能,术后复查胃酸、钡餐和胃镜等分别了解降酸率、胃排空情况、胆汁返流情况和胃粘膜病理变化,并与同期采用传统胃次全切除术式(Billorth术)病例对照。结果(1)BAO下降率为(87.25±6.37)%,MAO下降率为(83.42±8.28)%;(2)可见幽门开放、关闭,残胃可见收缩,钡剂2 h内自胃排空;(3)胆汁返流病例数比BillorthⅠ式和Ⅱ式分别下降57.33%和84.00%,而且程度轻;(4)胃粘膜病变数明显少于Billorth术式,且病变轻。结论PAFPG不仅有效地降低了胃酸,且有效地解决了传统胃次全切除术存在的胃动力学问题。
Objective To treat the conventional gastric kinetic problems of dumping, reflux and rdeention in the course of gastrectomy, 98 cases of peptic ulcer were treated by PAFPG. Methods Gastric vagus nerve was retained and gastric antrum lingual contour muscle flap was prepared so that the functions of pylorus and gastric antrum was retained. After the operation, rate of acid reduction, gastric emptying, bile reflux and pathological changes of gastric mucosa were observed by gastric acid test,barium meal and gastroscopy. Synchronously, other cases adopted -conventional subtotal gastrectomy as cont,＇ols. Results （1）BAO decreased by （87.25 ± 6.37） % ,MAO decrdased by （83.4±8. 28）%; （2） regular expansion and contraction of pylorus and peristaltic rushes of gastric remnant could be noted, Barium sulfate was emptied in two hours; （3）The number of cases of bile reflux decreased by 57.33% and 84.00%, respectively, compared with Billorth Ⅰ and Billorth Ⅱ, its level relieved; （4） The number of morbidity of gastric mucosa was significantly less than that in Billorth and its symptom relieved. Conclusion This type of gastrectomy can effectively prevent the gastric kinetic problems in the conventional subtotal gastrectomy.
出处
《江西医学院学报》
2005年第6期141-143,共3页
Acta Academiae Medicinae Jiangxi
关键词
幽门及胃窦
功能
胃切除
pylorus and gastric antrum
function
gastrectomy
