426例残胃纤维胃镜的随访观察

Follow- up observation of 426 cases with remnant stomach by fiberoptic gastroscopy

目的对４２６例残胃进行纤维胃镜随访观察。方法采用日本Ｏｌｙｍｐｕｓ各型纤维胃镜进行检查，对诊断结果进行分析。结果发现残胃病变依次为炎症４２２例（９９．１％）、溃疡９５例（２３．３％）、癌６６例（１５．５％）、息肉１１例（２．６％）。（１）残胃发生胆汁返流者占６１．７％，其中Ｂ－Ⅱ式较Ｂ－Ⅰ式易发生胆汁返流（Ｐ＜０．０５）。（２）良性病变较恶性病变术后易发生溃疡（Ｐ＜０．０５），溃疡易发生在吻合口，Ｂ－Ⅱ式较Ｂ－Ⅰ式术后溃疡发生率高（Ｐ＜０．０１）。（３）残胃复发癌占癌总数的８９．４％，与我区胃癌高发、就诊晚有关。（４）残胃息肉中腺瘤息肉占２７．３％。结论建议残胃胃镜普查。残胃癌的发生与随访年限、术式有关，但与术前是良或恶性病变无关（Ｐ＞０．０５）。

bjective To study the result of following up observation of 426 cases with remnant stomach by fiberoptic gastroscopy.Methods Fiberoptic gastroscopy was performed on 426 patients with remnant stomach. Results The order of frequency of diseases were listed as :Gastritis (422 cases with an incidence of 99.1%);Gastric Ulcer (95 cases with an incidence of 22.3%);Gastric Carcinoma (66 cases with an incidence of 15.5%);Gastric Polyps (11 cases with an incidence of 2.6%).Further more,diseases of remnant stomach was foud to be related to the style of operation;ages;sex;the time of following up and etcetera. ConclusionTt is necessary that the fiberoptic gastroscopy should be performed on patients with remnant stomach