胃空肠Roux-Y型吻合术预防胃大部分切除术后碱性反流性胃炎的研究

STUDIES OF PREVENTING AIKALINE REGURGIATION AFTER SUBTOTAL GASTRECTOMY IN ROUX-Y GASTROJEJUNOSTOMY

目的：研究评价胃空肠Roux—Y型吻合术预防胃大部分切除术后碱性反流性胃炎的作用，为其广泛应用提供临床资料和理论依据。方法：通过82例胃及十二指肠溃疡患者行胃大部分切除术后Roux—Y型吻合术，与68例毕氏Ⅱ式胃空肠吻合术后进行对照，观察早期胃肠减压引流的胃液及近远期上消化道症状，胃镜检查诊断碱性反流性胃炎。结果：82例Roux—Y吻合组3—5d后胃肠减压引流出的胃液中仅20例含有胆汁，其余胃液呈无色；68例毕氏Ⅱ式吻合组中，术后3—5d胃液中均有胆汁。术后3个月到8年随访，82例Roux—Y型吻合组中有2例反流性胃炎；68例结氏Ⅱ式吻合术中16例反流性胃炎。结论：Roux—Y型胃空肠吻合可预防胃大部分切除术后碱性反流性胃炎。

Objection： To resech and evaluate the function preventing aikaiine regurgitation after subtotal gastrectomy in Roux - Y gastrojejunostomy and providing clinic datum and date support. Method： By contrasting Roux - Y gastrojejunostomy after subtotal gastrectomy in 82 cases of gastroduodenal ulcer with Billroth - - Ⅱ gastrojejunstomy in 68 cases, observing gastric juices in gastrointestinal decompression in forepart and a specified futur date of the symptom upper gastroiutestinal. Diagnose alkaline reflux gastris by gastoscopy. Results ： Only 20 cases there are bile in gastric jiuces in 82 cases of Roux - Y gastrojejunostomy 3 -5 days later, but other gastric jiuces have no colour; In 68 cases Billroth - - Ⅱ gastrojejunostomy group operations, the gastric jiuces all contain bile 3 -5 days later . In the following observation from 3 months to 8 years , there are 2 cases of reflux ggastritis in 82 cases of Roux - Y gastrojejunostmy ; in 68 cases of Billroth - - Ⅱ gastrojejunostomy group operations, there are 16 alkaline regurgitations. Conclusions： Roux- Y gastrojejunostomy can guard against alkaline reflux gastritis.