论文部分内容阅读
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 efficacy of modified high-selective vagotomy in the treatment of patients with duodenal ulcer perforation. Methods Forty-eight patients with perforation of duodenal ulcer and 48 patients with duodenal ulcer perforation underwent gastric parotid vagotomy and gastric staphyloma dissection with kiss (suture) Analysis of 37 patients with surgery. Results In the two groups, the gastric acid secretion test of 5-pepsin: basal discharge (BAO), maximal acid output (MAO) and peak acid output (PAO) were respectively ± 1 2 8) mmol / h, (7 53 ± 3 6 9) mmol / h, (11 0 6 ± 4 2 3) mmol / h, (6 6 8 ± 2 2 3) mmol / 4 41 ± 6 18) mmol / h and (32 72 ± 12 2 5) mmol / h. The follow-up rate was 100%. Follow-up ranged from 3 months to 7 years. The median follow-up time was 3 years and 9 months. No recurrence was found in the treatment group. The control group recurred in 11 cases (30%) and reoperation in 4 cases (108%). Treatment effect according to the modified Visick classification: Ⅰ, Ⅱ grade treatment group 94%, control group 51%. Conclusion Modified high selective vagotomy for the treatment of perforation of duodenal ulcer has complete vagotomy, simple operation and few complications. Efficacy than simple suture repair.