PPVPG治疗幽门管溃疡穿孔28例疗效观察

Treatment of 28 perforation patients due to ulcer of pyloric canal with PPVPG.

目的探讨保留幽门及幽门迷走神经的胃大部切除术(PPVPG)治疗幽门管溃疡穿孔的疗效。方法对28例幽门管溃疡穿孔采用修补术加PPVPG。结果BAO与术前比较平均下降76·8%,术后MAO平均为10·11mEq/h;胃排空时间5例较快,22例(81·5%)正常;无1例出现倾倒综合征和腹泻;3例有轻度肠胃返流,24例无返流。平均随访8·5年,除1例术前误诊为单纯溃疡穿孔于术后第4个月死亡外,27例均健在。无1例溃疡复发,VisickⅠ、Ⅱ级占96·4%。结论PPVPG治疗幽门管溃疡穿孔的疗效满意,远期疗效有待进一步随访观察。

Objective To observe the curative effect of the tresis of pyloric canal ulcer with the operation of PPVPG. Methods Prosthesis plus PPVPG to cure 28 eases of the tresis of pylorie canal ulcer was adopted. Results The BAO descended averagely 76,8% less than that of pre - operation, the MAO of post - operation was average 10. llmEq/h; time of stomachic empty was relatively short in 5 cases and 22 cases（81.5%） were normal; no case got dumping syndrome and diarrhea; 3 cases had gently backstreaming of stomach and intestina, and 24 cases had not backstreaming. Through follow - up survey of average 8.5 years, 27 patients are still alive and in good health except one patient died 4 months post - operation because it was misdiagnosised as ulcer tresis only in pre - operation. No relapse occurred to the ulcer patients and the eases of Visick Ⅰ Ⅱ grades accounted for 96.4%. Conclusion PPVPG＇ s curative effect of the tresis of pyloric canal ulcer is good, and the forward curative effect should be observed in the further follow - up survey.