扩大高选择性迷走神经切除术加溃疡局部切除术治疗十二指肠溃疡临床研究

A clinical study on treatment of duodenal ulcer with expanding highly selected pneumogastric nerve and ulcer location resection

目的探讨扩大高选择性迷走神经切除术加溃疡局部切除术治疗十二指肠溃疡的临床疗效。方法经确诊的106例十二指肠溃疡(或并发穿孔、出血),采用扩大高选择性迷走神经切断加溃疡局部切除术治疗,并设对照组90例。手术前、后进行基础胃酸分泌量(BAO)、最大胃酸分泌量(MAO)和高峰胃酸分泌量(PAO)测定。结果治疗组均获治愈,获得12个月至10年随访者87例(82%),溃疡复发1例(0.94%)。对照组术后近期死亡1例(1.10%),吻合口狭窄4例(4.40%),胃炎15例(16.60%),吻合口溃疡3例(3.30%),溃疡复发3例(3.30%)。治疗组术后测定BAO、.PAO和MAO较术前下降显著(P<0.01)。结论扩大高选择性迷走神经切除术加溃疡局部切除术治疗十二指肠溃疡,达到病因、病灶双治疗,且不改变其正常解剖位置和胃的正常容积,疗效显著,是治疗十二指肠溃疡(或并发穿孔、出血)的优选术式。

Objective To evaluate the efficacy of expanding highly selected pneumogastric nerve and ulcer location resection on duodenal ulcer （DU）. Methods 196 patients suffering from DU were divided into two groups： the treatment group （106 cases） , and the control group （90 cases）. 106 patients received treatment with expanding highly selected pneu-mogastrie nerve and ulcer location resection. BAO, MAO and PAO were determined before and after operation. Results All patients in the treatment group were cured. The detelTnination of BAO , MAO and PAO after the operation was lower significantly than before the operation . Conclusion Patients suffering from DU can be cured radically with expanding highly selected pneumogastrie nerve and ulcer location resection , and there is no change in anatomical position of duodenum and volume of stomach . Expanding highly selected pneumogastric nerve and ulcer location resection has important clinical value.